Floating thrombus in the ascending aorta

Hisagi, Motoyuki; Morota, Tetsuro; Endo, M; Taketani, Tsuyoshi; Takamoto, Shinichi

doi:10.1007/s11748-006-0066-6

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…Ito et al (8) reported a case of the women receiving hormone replacing therapy, acute myocardial infarction and aortic thrombus located near the left coronary ostium. Several studies reported cases of aortic thrombus without any known etiology (9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

“…Various treatment modalities have been described in different forms and with variable success including thromboaspiration and surgery (5,9,17), thrombolysis (18), anticoagulate therapy alone (13). Exclusion of FFT with endovascular stent graft as a minimally invasive therapeutic option has been recently reported (20,21), however its role has not been fully established yet, regarding the long-term outcome.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Free floating thrombus in the non-atherosclerotic, non-aneurysmal ascending thoracic aorta: A rare entity

Joković¹,

Končar²,

Knežević³

et al. 2017

Medicinski časopis

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Free floating thrombus in the non-atherosclerotic, non-aneurysmal ascending thoracic aorta: A rare entity

Joković¹,

Končar²,

Knežević³

et al. 2017

Medicinski časopis

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“…The operation was performed 5 days after admission despite evidence of splenic embolization during the clinical course. 1 Even though the size of the thrombus was getting smaller with anticoagulation, we believe that surgery should have been performed earlier. Some previous reports have shown catastrophic consequences of a fl oating thrombus in the ascending aorta, such as acute myocardial infarct (AMI) and cerebrovascular accident (CVA).…”

Section: Regarding "Floating Thrombus In the Ascending Aorta" Hidetakmentioning

confidence: 94%

“…1 We congratulate them on their excellent result. We thoroughly agree with their prompt and aggressive workup, including transesophageal echocardiography, to detect a source of embolism.…”

mentioning

confidence: 93%

Regarding “Floating thrombus in the ascending aorta”

Wakiyama

Obo

2007

Gen Thorac Cardiovasc Surg

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We read with great interest the case report by Hisagi and associates. 1 We congratulate them on their excellent result. We thoroughly agree with their prompt and aggressive workup, including transesophageal echocardiography, to detect a source of embolism.There are several points to be discussed. First, we believe that the context may be misunderstood. They commented that the neurological event was suspected to be a transient ischemic attack, not a stroke/cerebral hemorrhage, which was confi rmed by magnetic resonance imaging. Therefore, the last sentence of the discussion is not consistent with their position.Second, the timing of the operation is a matter of concern. The operation was performed 5 days after admission despite evidence of splenic embolization during the clinical course. 1 Even though the size of the thrombus was getting smaller with anticoagulation, we believe that surgery should have been performed earlier. Some previous reports have shown catastrophic consequences of a fl oating thrombus in the ascending aorta, such as acute myocardial infarct (AMI) and cerebrovascular accident (CVA). 2-4 In reviewing those 12 reports, a fl oating thrombus in the ascending aorta had been associated with three AMIs (25%), three CVAs (25%), three peripheral embolisms (25%), and two visceral embolisms (17%) including one fatal superior mesenteric artery embolism. [2][3][4] We strongly suggest surgical removal of the fl oating thrombus in the ascending aorta as soon as possible when no contraindication for cardiopulmonary bypass exists, such as a cerebral infarct or hemorrhage (or both) and lethal liver dysfunction. To avoid the worst scenario, one should not procrastinate about surgery for this entity.Recently we encountered a case similar to that presented by Hisagi et al. The patient was a 62-year-old man transferred to our hospital with a shock vital due to AMI. Computed tomography showed a thrombus on the ascending aorta (Fig. 1), and coronary angiography revealed occlusion of the left main coronary trunk. Recanalization of the artery was accomplished while waiting for emergency surgery. A thrombus measuring 40 × 20 mm was attached to the left Valsalva sinus and extended to the proximal ascending aorta without a stalk. It was easily removed, and a stent placed at the left main trunk was confi rmed. The aortic valve, Valsalva sinus, and the ascending aorta were macroscopically normal. Coronary artery bypass grafting was performed concomitantly. The patient expired 5 days after the operation from low cardiac output syndrome.

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“…Za zmínku stojí několik případů, kde příčina vzniku trombu v nativní ascendentní aortě nebyla spolehlivě vysvětlena. [3][4][5][6][7][8] První dokumentovaný případ je z roku 1993 popsaný autory Farah a Hawawini, kdy trombus ascendentní aorty byl zdrojem mozkové embolizace. 3 Později Pousios a spol.…”

Section: Diskuse a Závěrunclassified

Rare cause of recurrent systemic embolism in a middle-aged woman with undiagnosed lung A-V malformation

et al. 2019

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Uvádíme případ opakované systémové embolie u dosud zdravé 48leté ženy, kdy postupný klinický vývoj odhalil kombinaci vzácných anatomických a patologických nálezů. Prvním projevem onemocnění u pacientky byla opakující se systémová embolizace do levé paže vyžadující opakovanou chirurgickou embolektomii ve velmi krátkém časovém sledu. Při souběžném pátrání po možném zdroji byla postupně diagnostikována klinicky němá plicní embolie, patentní foramen ovale a taktéž významná cévní arteriovenózní (AV) malformace v levé plíci. V dalším průběhu došlo k nečekanému zvratu v podobě vzniku akutního masivního infarktu myokardu, opět embolizačního původu, zdroj embolizace do levé koronární tepny byl překvapivě objeven v ascendentní aortě. Následující text podrobně popisuje průběh onemocnění této pacientky. Případ poukazuje mimo jiné na to, že i přes maximální a včasné diagnostické a terapeutické možnosti moderní kardiologie a interdisciplinární spolupráce stále existují vzácné a překvapivé případy pacientů s hyperkoagulačními stavy, u kterých příčinu nemocnosti neumíme zcela spolehlivě vysvětlit a i přes maximální úsilí a terapii může být velmi obtížné odvrátit případné další komplikace takového stavu.

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Floating thrombus in the ascending aorta

Cited by 10 publications

References 7 publications

Free floating thrombus in the non-atherosclerotic, non-aneurysmal ascending thoracic aorta: A rare entity

Free floating thrombus in the non-atherosclerotic, non-aneurysmal ascending thoracic aorta: A rare entity

Regarding “Floating thrombus in the ascending aorta”

Rare cause of recurrent systemic embolism in a middle-aged woman with undiagnosed lung A-V malformation

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