Document Detail

Floating intra-aortic thrombus presenting as distal arterial embolism.
MedLine Citation:
PMID:  19454418     Owner:  NLM     Status:  MEDLINE    
Floating thrombi in the aorta are a rare finding in the absence of any coagulation abnormality. They often represent a surgical emergency. Our case refers to a 45-year-old woman who presented with acute ischemia of the upper extremity. This was a result of peripheral embolism originating in a floating thrombus in the ascending aorta. A free-floating lesion held by a pedicle from the lateral ascending aortic wall was demonstrated using computed tomography and magnetic resonance scans. There was no pre-existing clotting abnormality. Conservative treatment with oral anticoagulation was not successful in removing the lesion. Therefore, a surgical approach was selected through a median sternotomy and cardiopulmonary bypass. Under temporary hypothermic circulatory arrest, the ascending aorta was opened. The lesion was removed along with a rim of aortic wall, circulation was re-established and the aorta was reconnected with use of a synthetic interposition graft. Postoperative course was uneventful. The patient was discharged on oral anticoagulation. Histopathology confirmed the lesion as thrombus. Only a few cases of intra-aortic thrombus without any coagulation abnormality basis are described in literature. Occasionally, they present as distal embolism. Treatment should be surgical excision on cardiopulmonary bypass, a procedure performed safely with excellent outcome.
Dimitrios Pousios; Theodoros Velissaris; Simon Duggan; Geoff Tsang
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-18
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-18     Completed Date:  2009-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  532-4     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Wessex Cardiac Unit, Southampton General Hospital, Southampton, UK.
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MeSH Terms
Acute Disease
Administration, Oral
Anticoagulants / administration & dosage
Aortic Diseases / complications*,  diagnosis,  therapy
Aortography / methods
Blood Vessel Prosthesis Implantation
Cardiopulmonary Bypass
Circulatory Arrest, Deep Hypothermia Induced
Embolism / diagnosis,  etiology*,  therapy
Ischemia / diagnosis,  etiology*,  therapy
Ischemic Attack, Transient / etiology
Magnetic Resonance Angiography
Middle Aged
Sternum / surgery
Thrombosis / complications*,  diagnosis,  therapy
Tomography, X-Ray Computed
Treatment Failure
Upper Extremity / blood supply*
Reg. No./Substance:

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