By A 56-year-old man experienced severe chest pains and difficulty breathing for two days before coming into the ER. The doctors couldn’t find the source of the problem until they opened him up. They then removed a 4-inch piece of cement from his heart.
A Painful Complication
According to a report from The New England Journal of Medicine, the man had gone in for spinal surgery just a week before his symptoms started to appear. The surgery was for a broken vertebra or what doctors call a “vertebral compression fracture,” a very painful condition in which part of a spine bone (vertebra) collapses into itself. According to the National Institutes of Health, it is often caused by osteoporosis and bone weakening.
During the procedure, the man received a kyphoplasty, which is when doctors inject a special type of cement into the vertebra to restore its proper height and keep it from collapsing.
The procedure is generally considered safe. Less than 2% of those undergoing the procedure experience complications, according to data from the American Association of Neurological Surgeons.
But a kyphoplasty comes with one serious potential risk. The cement can leak from the bone into other areas, which can cause a blockage or “embolism” of a blood vessel.
The authors say this is exactly what happened to the man in question. The cement leaked from the bone into his veins, where it hardened and embolized before traveling to his heart.
“An extensive study on the matter suggests that the spinal cord surgery that the 56-year-old man went through had a say in the cement deposit in his chest,” said one of the doctors involved with the procedure.
When he went back to the hospital, the man received a CT scan and x-ray, which showed a foreign body in his heart. The doctors then performed emergency heart surgery, during which they found a thin, sharp piece of cement that had torn through the right upper chamber of his heart and punctured his right lung, according to the report.
They then removed the shard of cement, which measured 4 inches (10.1 centimeters) long and 0.08 inches wide. Doctors quickly repaired the tear in his heart.
The report says that the man had no other complications from the procedure. Nearly a month later, the man was nearly fully recovered.
A First of Its Kind?
This wasn’t the first time doctors have found a large piece of cement in a person’s chest.
A case report in the European Heart Journal – Case Reports titled, “A spear to the heart—the accidental discovery of a giant cement embolism in the right heart: a case report,” researchers detail what happened after a 57-year-old man received a kyphoplasty in Germany.
The man experienced shortness of breath and chest pain before going to the ER. Doctors then found a “huge cement embolus” in his heart.
The case report says the rate of cardiopulmonary cement embolism after such vertebral body procedures ranges from 0% to 23%. Those odds are hard to swallow.
Patients won’t like knowing that they have a 23% chance of seeing cement flow around their heart.
Those numbers were confirmed in a 2009 issue of the European Spine Journal, which indicates that “the risk of a pulmonary embolism ranges from 3.5 to 23%” after cement using procedures like balloon kyphoplasty and percutaneous vertebroplasty are used to fix osteoporotic fractures.
The question then becomes what can be done to make these procedures safer for patients or whether alternative procedures should be considered.
Experts say not all embolisms pose a risk to your health, but no one wants to have a stone heart.
