https://orcid.org/0009-0007-9428-7805
A 76-year-old male patient presented to the emergency department exhibiting symptoms suggestive of foreign bodies within the digestive tract, accompanied by complaints of cardiac fatigue and dyspnoea over recent days. Computed Tomography (CT) examination of the chest and abdomen revealed an absence of identifiable foreign bodies within the digestive tract. However, a region of heightened density was observed in the right atrium–right ventricular septum, along with a high-density shadow within the inferior vena cava that exhibited a contiguous connection to the same shadow emanating from the L4 vertebral body (Panels A–F). Reviewing the history, it was noted that the patient had undergone percutaneous vertebroplasty procedures for the L4 and T11–12 vertebrae. Subsequent postoperative X-rays exhibited the presence of a high-density abdominal strip and, notably, the subsequent rupture and displacement of the high-density striae after 1 month (Panels G–J). Further CT imaging delineated the localization of the high-density image within the inferior vena cava, extending to the intrahepatic level.
The patient underwent cardiac foreign body extraction via extracorporeal circulation. Intraoperatively, a 12 cm segment of bone cement was discovered to have penetrated the right atrium, with its distal end reaching the right ventricular septum, exhibiting a 1 cm bifurcation at the distal end. Subsequent analysis confirmed the foreign body to be attributed to bone marrow mud leakage following the initial surgery. It is postulated that inadvertent injury to the adjacent vertebral vein during the surgical procedure facilitated retrograde flow of bone cement into the heart via the inferior vena cava.
Supplementary data are not available at European Heart Journal online.
All authors declare no disclosure of interest for this contribution.
The data used to support the findings of this study are included within the article.
