Bone cement embolism causing right ventricle perforation

Bone cement embolism is one of major complications of percutaneous kyphoplasty. Although rare, the intracardiac cement embolism is potentially life-threatening, with a documented incidence of 3.9%, and it is even more infrequent if symptomatic (0.3%).

Herein, we reported an extremely rare case of intracardiac bone cement embolism after percutaneous kyphoplasty causing right ventricle perforation. A 70-year-old woman, experiencing sudden left chest pain with radiation to the shoulder for 9 h, was transferred to our emergency department. Two hours before onset of her symptoms, she underwent percutaneous kyphoplasty at the local hospital. The computed tomography angiography revealed that an intracardiac foreign body penetrated her right ventricle. In light of her surgical history, bone cement embolism was suspected and thus, the patient was transferred to our center. Computed tomography and echocardiography confirmed the presence of intracardiac linear-shaped foreign body perforating the right ventricle. Therefore, the patient underwent open-heart surgery and the bone cement was removed successfully.

Symptomatic intracardiac bone cement embolism is potentially fatal, so the rapid diagnosis and prompt treatment measures based on the cement emboli characteristics and the patient's condition are crucial.