A Fishbone-Like Bone Cement Fragment Crossing the Tricuspid Valve and Penetrating the Septum: Rare Sequela of Percutaneous Vertebroplasty

Percutaneous vertebroplasty is a commonly used minimally invasive procedure for osteoporotic or metastatic vertebral compression fractures, but cement leakage is frequent and, in rare cases, may enter the paravertebral venous system, migrate to the azygos vein and inferior vena cava, and finally reach the right atrium or ventricle, leading to severe complications such as arrhythmia, cardiac perforation, or pulmonary embolism.We report a case of delayed intracardiac cement embolism occurring 1 year after vertebroplasty.A 77-year-old woman presented with recurrent dizziness, palpitations, and precordial stabbing pain.Echocardiography and computed tomography revealed a linear high-density fragment extending across the tricuspid valve into the right heart chambers (Figure 1).Open-heart surgery under cardiopulmonary bypass removed a 7-cm fishbone-shaped cement