Catching a floating thrombus; a case report on the treatment of a large thrombus in the ascending aorta

Journal of Cardiothoracic Surgery
Gijs Eduard de MaatEhsan Natour

Abstract

The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. A healthy 48-year-old man was hospital admitted with acute abdominal pain. CT-scan showed a right renal embolism in presence of a defect in the distal ascending aorta suggestive for thrombus. After heart team discussion the patient was scheduled for surgery and successfully underwent an emergent thrombus removal. Also, owing to multiple aortic wall insertions, the ascending aorta was replaced. The patient's recovery was uneventful and histological examination showed no signs of connective tissue disorders of aortic wall while confirmed the thrombotic nature of the mass. We present a patient with a floating thrombus in the ascending aorta who underwent an ascending aorta replacement. While angio-CT scan led to a prompt diagnosis, intraoperative epi-aortic echocardiography allowed to define precise location of t...Continue Reading

References

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Sep 28, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·C StöllbergerJ Finsterer
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Dec 18, 2015·Interactive Cardiovascular and Thoracic Surgery·Alessandro MalobertiCristina Giannattasio

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Citations

Aug 18, 2018·Journal of Cardiovascular and Thoracic Research·Mustafa HoumsseAhmet Kilic
Sep 27, 2018·Asian Cardiovascular & Thoracic Annals·Alfonso CampanileClaudio Cavallini
Mar 5, 2019·The International Journal of Cardiovascular Imaging·Mengying YueHao Zhang
Sep 6, 2019·Journal of Cardiothoracic Surgery·Baogang WangXiaxia Man
Nov 18, 2018·Clinical Practice and Cases in Emergency Medicine·Dean KerenickJulian Jakubowski
Nov 30, 2020·Annals of Vascular Surgery·Yen-Yu ChenFan-Yen Lee

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