| Floating intra-aortic thrombus presenting as distal arterial embolism. | |
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MedLine Citation:
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PMID: 19454418 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Dimitrios Pousios; Theodoros Velissaris; Simon Duggan; Geoff Tsang |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-05-18 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 9 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-18 Completed Date: 2009-10-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 532-4 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery, Wessex Cardiac Unit, Southampton General Hospital, Southampton, UK. dpousios@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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 Female Humans 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* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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