scholarly journals Large mural thrombus in the non-aneurysmal and non-atherosclerotic ascending aorta: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiaoyi Dai ◽  
Chengyao Ni ◽  
Wenzong Luo ◽  
Sihan Miao ◽  
Liang Ma
Keyword(s):  
Anterior Wall ◽  
Ascending Aorta ◽  
Preoperative Imaging ◽  
Uneventful Recovery ◽  
Surgical Removal ◽  
Mural Thrombus ◽  
Aortic Thrombus ◽  
Thrombotic Complications ◽  
Aorta Replacement ◽  
Atherosclerotic Ascending Aorta

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.

scholarly journals Large Mural Thrombus in the Non-Aneurysmal and Non-atherosclerotic Ascending Aorta: A Case Report

2021 ◽  
Author(s):  
Xiaoyi Dai ◽  
Chengyao Ni ◽  
Wenzong Luo ◽  
Sihan Miao ◽  
Liang Ma
Keyword(s):  
Anterior Wall ◽  
Ascending Aorta ◽  
Preoperative Imaging ◽  
Uneventful Recovery ◽  
Surgical Removal ◽  
Mural Thrombus ◽  
Aortic Thrombus ◽  
Thrombotic Complications ◽  
Aorta Replacement ◽  
Atherosclerotic Ascending Aorta

Abstract BackgroundThe 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 PresentationWe 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.ConclusionsAnticoagulant 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.

scholarly journals Floating thrombus in the ascending aorta revealed by peripheral arterial embolism

2020 ◽  
Vol 30 (5) ◽  
pp. 762-764
Author(s):  
Majdi Gueldich ◽  
Mariantonietta Piscitelli ◽  
Haytham Derbel ◽  
Khaoula Boughanmi ◽  
Eric Bergoend ◽  
...  
Keyword(s):  
Aortic Wall ◽  
Arterial Embolization ◽  
Ascending Aorta ◽  
Surgical Removal ◽  
Systemic Embolism ◽  
Arterial Embolism ◽  
Floating Thrombus ◽  
Aortic Thrombus ◽  
Surgical Thrombectomy ◽  
Peripheral Arterial

Abstract A floating thrombus in the ascending aorta is rarely found in clinical practice and is an uncommon cause of peripheral arterial embolization. When there is minimal atherosclerosis or a normal aorta, the management of such a lesion is poorly defined. Currently, there is no clear consensus concerning optimal treatment. Herein, we report 2 cases of ascending aortic thrombus that are complicated by a peripheral embolic event. Due to the risk of recurrent systemic embolism, particularly with strokes, surgical thrombectomy with ascending aortic wall replacements was performed. We believe that floating ascending aorta thrombus represents a serious source of systemic embolism and stroke. Surgical removal is easy to perform with good clinical outcomes. Conservative treatments such as anticoagulation or thromboaspiration may be considered in high-risk or inoperable patients.

scholarly journals Asymptomatic floating thrombus in the ascending aorta depicted on four-dimensional computed tomography

2020 ◽  
Vol 8 ◽  
pp. 2050313X2097189
Author(s):  
Takamasa Nishimura ◽  
Eijun Sueyoshi ◽  
Yuichi Tasaki ◽  
Masataka Uetani
Keyword(s):  
Computed Tomography ◽  
Unusual Case ◽  
Ascending Aorta ◽  
Mural Thrombus ◽  
4D Ct ◽  
Floating Thrombus ◽  
Contrast Enhanced ◽  
Aortic Thrombus ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Aortic mural thrombi of the ascending aorta are rare. If an aortic mural thrombus is dislodged, it can cause various embolic complications, which can sometimes be fatal. Although contrast-enhanced computed tomography (CT) and transesophageal echography are useful for diagnosing aortic mural thrombi, four-dimensional CT (4D-CT) is one of the most useful modalities for both diagnosis and treatment selection in such cases. 4D-CT can be used to evaluate the morphology and mobility of thrombi. Furthermore, it is minimally invasive. To the best of our knowledge, there have not been any reports about 4D-CT being used to depict an asymptomatic ascending aortic thrombus. We report a very unusual case, involving an aortic mural thrombus of the ascending aorta.

Thoracic Aortic Mural Thrombus, Right Ventricular Clot and Pulmonary Embolism in a Patient With COVID-19 Pneumonia

2020 ◽  
pp. 153857442096610
Author(s):  
Marc Masana ◽  
Lucia I. Martinez ◽  
Miquel Gil ◽  
Gonzalo Bueno ◽  
Secundino Llagostera
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Vascular Complications ◽  
Low Molecular Weight ◽  
Mural Thrombus ◽  
Ct Angiogram ◽  
Aortic Thrombus ◽  
High Incidence ◽  
Thrombotic Complications ◽  
In Transit

Since the outbreak of the COVID-19 pandemic, increasing evidence suggests that infected patients present a high incidence of thrombotic complications. We report a 67-year-old-woman admitted for severe acute respiratory syndrome coronavirus 2 infection. Chest CT images showed bilateral ground glass opacities, bilateral pulmonary embolism, right ventricular clot in transit and 2 thoracic aortic mural thrombus. Therapy was initiated with subcutaneous low-molecular-weight heparin, and the patient was discharged at 20 days asymptomatic. Complete resolution of the aortic thrombus was observed in a 1-month surveillance CT angiogram. Our case illustrates vascular complications in a COVID-19 patient and its effective treatment with anticoagulation.

Partial Clamping of the Brachiocephalic Trunk for Total Ascending Aorta Replacement without Circulatory Arrest: Early and Midterm Results

2004 ◽  
Vol 7 (3) ◽  
pp. E201-E207
Author(s):  
Antonio Maria Calafiore ◽  
Michele Di Mauro ◽  
Carlos-A. Mestres ◽  
Gabriele Di Giammarco ◽  
Giovanni Teodori ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Midterm Results ◽  
Brachiocephalic Trunk ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Anterior Mediastinal Paraganglioma Mimicking Thymoma

2012 ◽  
Vol 15 (3) ◽  
pp. 170
Author(s):  
Hee Moon Lee ◽  
Dong Seop Jeong ◽  
Pyo Won Park ◽  
Wook Sung Kim ◽  
Kiick Sung ◽  
...  
Keyword(s):  
Mediastinal Mass ◽  
Aortic Wall ◽  
Anterior Wall ◽  
Ascending Aorta ◽  
Anterior Mediastinal Mass ◽  
Arterial Reconstruction ◽  
Ct Evaluation ◽  
One Year ◽  
Mediastinal Paraganglioma

A 54-year-old man was referred to our institution with hemoptysis and hoarseness of 1 year's duration. A computed tomography (CT) scan showed an anterior mediastinal mass (2.5 cm x 1.0 cm), which was diagnosed as thymoma. The tumor was resected under a sternotomy. The tumor had invaded the anterior wall of the ascending aorta. With the patient under cardiopulmonary bypass, the aortic wall invaded by the mass was resected, and arterial reconstruction was performed with patch material. The tumor was revealed to be a tumor of neuronal origin. The patient's postoperative course was uneventful. The patient was discharged on postoperative day 9. One year after the operation, a follow-up chest CT evaluation showed no specific complications or recurrence.

Intravascular Ultrasound Findings of BioGlue Surgical Adhesive Coronary Embolism After Ascending Aorta Replacement

2021 ◽  
Vol 14 (4) ◽  
pp. e39-e41
Author(s):  
Masashi Yokoi ◽  
Hiroshi Fujita ◽  
Tatsuhito Ogawa ◽  
Tsuyoshi Ito ◽  
Yoshihiro Seo ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ascending Aorta ◽  
Surgical Adhesive ◽  
Ultrasound Findings ◽  
Aorta Replacement ◽  
Coronary Embolism ◽  
Ascending Aorta Replacement

Back-Table Modified Stent-Graft for Endovascular Repair of Ascending Aorta

2021 ◽  
pp. 152660282110282
Author(s):  
Juan Shi ◽  
Ligang Liu ◽  
Xiang Wei ◽  
Mingjia Ma
Keyword(s):  
Endovascular Repair ◽  
Survival Rates ◽  
Ascending Aorta ◽  
Cerebellar Infarction ◽  
Type Ia ◽  
Risk Patients ◽  
Aorta Replacement ◽  
Aortic Dissections ◽  
Event Rates

Objectives To investigate the effectiveness of modified stent-grafts (SGs) for the management of ascending aortic pathologies. Materials and Methods From January 2015 to December 2019, 31 individuals were treated by ascending aortic endovascular repair with a back-table modified SG for acute (n=4) or chronic (n=1) type A aortic dissections, penetrating aortic ulcers (n=18), pseudoaneurysms (n=2), anastomotic fistula (n=1), and endoleaks after thoracic endovascular aortic repair (TEVAR) (n=5). The commercially available thoracic aortic SGs were modified with a fenestration or truncation technique on the back-table according to aortography during the operation. Results The 30-day mortality and aorta-related mortality rates were 12.9% and 6.5%, respectively. There were 2 strokes, 3 respiratory insufficiencies, and 6 endoleaks during hospitalization. During a mean follow-up of 28.8±16.6 months, the overall survival rates at 1 year and 3 years were both 80.6%. Free from adverse event rates at 1 year and 3 years were 88.9% and 84.7%, respectively. There were 2 deaths during follow-up: One patient died of cachexia 1 month after discharge, and the other patient died of acute myocardial infarction 3 months after discharge. One patient with a pseudoaneurysm underwent open ascending aorta replacement 3 months after discharge for a type Ia endoleak. Another patient suffered from cerebellar infarction 17 months after discharge. Conclusion The modified SG for endovascular repair of the ascending aorta is a practicable alternative and presents acceptable outcomes in high-risk patients.

Early safety performance of a modified technique of aorta replacement with sinotubular stabilization

2021 ◽  
pp. 021849232110150
Author(s):  
Marco Moscarelli ◽  
Nicola Di Bari ◽  
Giuseppe Nasso ◽  
Khalil Fattouch ◽  
Thanos Athanasiou ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Aortic Insufficiency ◽  
Ascending Aorta ◽  
Safety Performance ◽  
Modified Technique ◽  
Sinotubular Junction ◽  
Aorta Replacement ◽  
Valve Sparing ◽  
Ascending Aorta Replacement

Background We sought to determine if a modified technique for ascending aorta replacement with sinotubular junction reduction and stabilization was safe. Methods This technique was performed by suspension of the three commissures, invagination of the aortic Dacron graft and advancing the graft into the ventricles. We included patients with dilatation of the ascending aorta, normal sinuses of Valsalva dimension (<45 mm), with or without aortic annulus enlargement (>25 mm) and with various degree of aortic insufficiency (from grade 1 to 3). Results From April to October 2019, 20 patients were recruited from two centers; mean age was 66.9 ± 12.8 years, 13 were male; grade 1, 2 and 3 was present in 12, 2 and 6 patients, respectively. All patients underwent ascending aorta replacement with modified technique; an additional open subvalvular ring was used in 8 patients with aortic insufficiency ≥ 2; cusps repair was performed in 6 patients (5 plicating central stitches/1 shaving); concomitant coronary artery bypass grafting was performed in 10 patients. There was no 30-day mortality. One patient was re-explored for bleeding. All patients completed six-month follow-up; at the transthoracic echocardiography, there was no aortic insufficiency ≥ 1 except one patient with aortic insufficiency grade 1 who underwent ascending aorta replacement and subvalvular ring; no patients underwent reintervention. Conclusions This modified technique for ascending aorta replacement and sinotubular junction stabilization was safe. It could be associated with other aortic valve sparing techniques. However, such remodeling approach has to be validated in a larger cohort of patients with longer follow-up.

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