Perforation of Cardiac Wall by Cement Embolism after Vertebral Augmentation for Thoracic Spinal Fracture: A Case Report

Abstract

We describe a rare case of cardiac perforation caused by cement emboli after vertebral augmentation technique two months after the procedure. The patient was sent to a local hospital due to progressive dyspnea and chest tightness. Massive pericardial effusion was first diagnosed at the hospital, and therefore he was transferred to our hospital's emergency department. Multidetector computed tomography (MDCT) showed a string-like foreign body over the right atrium and ventricle which had apparently caused perforation of cardiac wall. Under the diagnosis of cement spike perforation, we performed percutaneous endovascular retrieval. We failed to extract the cement due to its fragile characteristic of the fragment and further migration of cement into the right middle lobe of lung was noted. The patient's symptoms improved after the penetrating emboli was removed from the cardiac wall, and no symptoms of pulmonary embolism occurred. The patient was discharged 5 days later with aspirin treatment for prevention of pulmonary embolism.