Figure 1.

Images of patient 1. A: CTA showed a U-shaped high-density shadow in the right atrium; B: intraoperative cardiac surgery status; C: bone cement plugs removed during surgery. CTA: computed tomography angiography.

Table 1.

The detailed information of the four intracardiac cement embolism patients

Figure 2.

Three dimensional echocardiography in patient 2. A long strip of hyperechogenicity can be seen in the right heart, with a length of about 4.55 cm and a diameter of about 0.47 cm. The boundary was clear, starting from the inferior vena cava near the right atrial entrance, crossing the tricuspid valve and extending to the right ventricle. There was obvious activity at the free end of the right ventricle, which did not cause mechanical obstruction of the tricuspid valve and did not adhere to the tricuspid valve leaflets. Considering the medical history, bone cement should be considered first.

Figure 3.

Three dimensional echocardiography in patient 3. Hyperechogenicity (6.24 cm) was found in the right ventricle, partially passing through the tricuspid valve and entering the right atrium.

Figure 4.

Three dimensional echocardiogram of the heart in patient 4. A strong echo can be seen in the right heart, with a length of about 7.61 cm and a diameter of about 0.48 cm.