Abstract
We present a case of floating thrombus originating from an almost normal thoracic aorta in a 54-year-old man who presented with acute arterial occlusion of his left leg. Transesophageal echocardiography (TEE), computed tomography, and magnetic resonance imaging showed two masses in an almost normal aorta after embolectomy for the acute arterial occlusion. Although the embolus was thrombus histologically, malignant tumors could not be ruled out. The masses did not decrease in size after 7 days of anticoagulant therapy, so they were extirpated under cardiopulmonary bypass (CPB) and TEE guidance. Frozen section examination during CPB indicated that there was no evidence of malignancy in the removed mass. TEE played an important role in the diagnosis and surgery of this condition, and it was useful when deciding on a surgical strategy. Because the treatment strategy for this disease remains controversial, further studies are needed.
Similar content being viewed by others
References
Modi BP, Longo MJ, Kopf GS, Elefteriades JA. Surgical management of giant descending aortic thrombus detected by transesophageal echocardiography. Int J Angiol 2000;9:243–245.
Laperche T, Laurian C, Roudant R, Steg PG. Mobile thrombus of the aortic arch without aortic debris: a transesophageal echocardiographic finding associated with unexplained arterial embolism. Circulation 1997;96:288–294.
Choukroun EM, Labrousse LM, Madonna FP, Deville C. Mobile thrombus of the thoracic aorta: diagnosis and treatment in 9 cases. Ann Vasc Surg 2002;16:714–722.
Gouëffic Y, Chaillou P, Piller JC, Duveau D, Patra P. Surgical treatment of nonaneurysmal aortic arch lesions in patients with systemic embolization. J Vasc Surg 2002;36:1186–1193.
Hirata Y, Ono M, Morita T, Takamoto S. Recurrent embolism caused by floating thrombus originating from the ligamentum arteriosum. Eur J Cardiothorac Surg 2003;24:452–454.
Laperche T, Sarkis A, Monin JL, Laurian C, Gigou F, Cormier JM, et al. The ligamentum arteriosum: an unreported origin of peripheral emboli diagnosed by transesophageal echocardiography. Am Heart J 1992;124:222–223.
Walther T, Mochalski M, Falk V, Mohr FW. Resection of a thrombus floating in the aortic arch. Ann Thorac Surg 1996;62: 899–901.
Hassan I, Zehr KJ, Freeman WK. A case of asymptomatic thoracic aorta mural thrombi. Ann Thorac Surg 2001;72: 1735–1737.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Namura, O., Sogawa, M., Asami, F. et al. Floating thrombus originating from an almost normal thoracic aorta. Gen Thorac Cardiovasc Surg 59, 612–615 (2011). https://doi.org/10.1007/s11748-010-0752-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-010-0752-2