Surgical removal of intracardiac-intrapulmorary orthopedic cement embolism after percutaneous vertebroplasty

Introduction: Percutaneous vertebroplasty is increasingly used for the minimally invasive treatment of vertebral osteoporotic fractures. A cement leakage outside the vertebral body could be a source of serious complications.

Aims: We report a 77-year-old patient who was referred with intracardiac and central pulmoray bone cement embolism after percutaneous vertebroplasty of the fifth lumbal vertebral body. The patient underwent an urgent open heart surgery. Using the heart-lung machine with moderate hypothermia without crossclamping the aorta, the cement embolism was effectively removed from the right atrium-right ventricle-main pulmoray trunk-left pulmonary artery. After uneventful recovery the patient was discharged on the 8^th postoperative day with a recommendation of six-month oral anticoagulation therapy.

Discussion: Current studies showed an incidence as high as 23% of asymptomatic cement embolism after percutaneous vertebroplasty. Close clinical monitoring of these patients is needed to detect any serious complication and facilitate prompt treatment.