Xiaoyi Dai1,2, Chengyao Ni1, Wenzong Luo1, Sihan Miao1,2, Liang Ma3. 1. Department of Cardiovascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, Zhejiang, 310003, China. 2. School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China. 3. Department of Cardiovascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, Zhejiang, 310003, China. ml1402@zju.edu.cn.
Abstract
BACKGROUND: The mural thrombus in the ascending aorta is rare, most of which are associated with aneurysm or atherosclerotic lesions, with high risks of causing catastrophic thrombotic events. A mural thrombus in the non-aneurysmal and non-atherosclerotic ascending aorta is exceptionally uncommon. CASE PRESENTATION: We reported a large mural thrombus in normal ascending aorta of an asymptomatic patient. Preoperative imaging confirmed the presence of the sessile thrombus located at the left anterior wall of ascending aorta. Given that it had the potential to cause fatal thrombotic complications, surgical removal and segment of ascending aorta replacement were executed. The patient had an uneventful recovery and discharged 14 days after surgery. CONCLUSIONS: Anticoagulant is the therapeutic cornerstone of ascending aortic thrombus, but surgery should be performed aggressively when the thrombus is large or floating to avoid severe embolic complications or recurrence.
BACKGROUND: The mural thrombus in the ascending aorta is rare, most of which are associated with aneurysm or atherosclerotic lesions, with high risks of causing catastrophic thrombotic events. A mural thrombus in the non-aneurysmal and non-atherosclerotic ascending aorta is exceptionally uncommon. CASE PRESENTATION: We reported a large mural thrombus in normal ascending aorta of an asymptomatic patient. Preoperative imaging confirmed the presence of the sessile thrombus located at the left anterior wall of ascending aorta. Given that it had the potential to cause fatal thrombotic complications, surgical removal and segment of ascending aorta replacement were executed. The patient had an uneventful recovery and discharged 14 days after surgery. CONCLUSIONS: Anticoagulant is the therapeutic cornerstone of ascending aortic thrombus, but surgery should be performed aggressively when the thrombus is large or floating to avoid severe embolic complications or recurrence.
Authors: Jan N Hilberath; Daryl A Oakes; Stanton K Shernan; Bernard E Bulwer; Michael N D'Ambra; Holger K Eltzschig Journal: J Am Soc Echocardiogr Date: 2010-11 Impact factor: 5.251
Authors: Sebastian Pagni; Jaimin Trivedi; Brian L Ganzel; Matthew Williams; Nick Kapoor; Charles Ross; A David Slater Journal: Ann Thorac Surg Date: 2011-05-06 Impact factor: 4.330