Key result
Surgical removal of a giant floating thrombus from the ascending aorta to the arch, along with thromboendarterectomy and aortic wall reconstruction, resulted in a satisfactory outcome with improved mobility and speech at 6 months follow-up.
Why the study?
Large mural thrombi in the ascending aorta are extremely uncommon and risk major embolic events, making their management challenging, controversial, and highly individualized.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Surgical removal of a giant floating thrombus in the ascending aorta and arch using deep hypothermic circulatory arrest is a viable and effective strategy to prevent catastrophic embolic events.
Large mural thrombi in the relatively normal ascending aorta are extremely uncommon conditions that may lead to major adverse cardiovascular events due to new embolism. Because of their changeable variations, the management of these unstable thrombi is challenging and controversial. The size, morphology, location, embolic involvement, and patients' conditions are all crucial for therapeutic decision-making. Treatment options include anticoagulation, thrombolysis, surgical thrombectomy, and endovascular stenting. Therefore, surgical strategies should be highly individualized. Herein, we present a rare case of a huge thrombus from the ascending aorta to the arch in a 43-year-old man. Considering the high risks of catastrophic embolic events, surgical removal of the aortic mass, thromboendarterectomy, and reconstruction of the arterial wall were performed with a satisfactory outcome. This report illustrates our experience of surgical strategies and perioperative treatments for this challenging case, and contemporary surgical management for mural thrombi in the ascending aorta was also thoroughly discussed.
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Li et al. (2023) conducted a case report in Giant thrombus from the ascending aorta to the arch (n=1). Surgical removal of the aortic mass, thromboendarterectomy, and reconstruction of the arterial wall was evaluated on Clinical outcome. Surgical removal of a giant floating thrombus from the ascending aorta to the arch, along with thromboendarterectomy and aortic wall reconstruction, resulted in a satisfactory outcome with improved mobility and speech at 6 months follow-up.
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