Massive mass embolism detected by transesophageal echocardiography in bone cement implantation syndrome: a case report

JA Clin Rep. 2019 Jan 24;5(1):5. doi: 10.1186/s40981-019-0225-2.

Abstract

Bone cement implantation syndrome (BCIS) is a known complication in patients undergoing cemented orthopedic surgeries; however, the etiology and pathophysiology of BCIS are not fully understood. We report the case of a patient who developed pulseless electrical activity (PEA) due to BCIS after cemented femoral head replacement. Transesophageal echocardiography (TEE) during PEA revealed a massive embolus extending from the main pulmonary artery to the inferior vena cava. Of note, this embolus disappeared completely and rapidly after return of spontaneous circulation. TEE proved to be useful in the diagnosis and management of this case of PEA.

Keywords: Bone cement implantation syndrome (BCIS); Cemented orthopedic surgeries; Pulmonary embolism (PE); Transesophageal echocardiography (TEE).