Why the study?
Floating thrombus in the ascending aorta is rare, and its optimal management is poorly defined when there is minimal atherosclerosis or a normal aorta.
Surgical thrombectomy with ascending aortic wall replacement is a viable treatment for floating ascending aorta thrombus to prevent recurrent systemic embolism.
May support surgical thrombectomy in select aortic thrombus cases; hypothesis-generating and does not yet inform practice.
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.
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Gueldich et al. (2020) studied this question.
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