A giant floating thrombus in the ascending aorta: a case report
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CASE REPORT
A giant floating thrombus in the ascending aorta: a case report Peng Yang1†, Ya Li2†, Yao Huang1, Chen Lu1, Weitao Liang1 and Jia Hu1*
Abstract Background: A floating thrombus in an ascending aorta with normal morphology is very rare, but when it does occur, it may induce a systemic embolism or fatal stroke. The pathophysiological mechanisms of aortic mural thrombi remain unclear, and there is no consensus regarding therapeutic recommendations. Case presentation: We report a 49-year-old male who presented with chest discomfort for 5 days and was admitted to our emergency unit. A contrast-enhanced computed tomography angiography (CTA) surprisingly demonstrated a large filling defect suggestive of a thrombus in his otherwise healthy distal ascending aorta. Surgical resection of the mass and attachment site was performed. Histological examination confirmed that the mass was a thrombus, but the cause of the thrombus formation was unknown. Conclusions: floating aortic thrombi are rare, and they are prone to break off, thus carrying a potential risk for embolic events with catastrophic consequences. Surgical resection, both of the aortic thrombus and attachment site, as well as postoperative anticoagulant administration, are standard treatments. Keywords: Floating thrombus, Ascending aorta, Surgery Background An aortic mural thrombus (AMT) without an aneurysm or dissection is rare, with an incidence rate of about 0.45% [1]. It is occasionally identified incidentally, either by a source of systemic emboli or by computed tomography angiography (CTA). The most common locations for AMTs are the aortic isthmus, descending thoracic aorta and lower abdominal aorta, with the rarest location being the ascending aorta [2–4]. The pathogenesis and treatment strategies for AMTs are still limited to those found in case reports, and there is no consensus. We report on a 49-year-old male who presented with chest discomfort for 5 days and was admitted to our emergency unit. Contrast-enhanced computed tomography angiography (CTA) showed the presence of an ascending aorta active *Correspondence: [email protected] † Peng Yang and Ya Li contribute equally to this work 1 Department of Cardiovascular Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Alley, Chengdu 610041, China Full list of author information is available at the end of the article
occupancy, which was successfully resected surgically. Histological examination of the mass confirmed that it was a thrombus.
Case presentation A 49-year-old man presented with chest discomfort for 5 days and was admitted to our emergency unit. His medical history was unremarkable, except for cigarette smoking and a lower left limb embolic event that was treated by surgical embolectomy 3 years prior. Electrocardiography and laboratory tests were normal. A contrast-enhanced CTA surprisingly demonstrated a large filling defect suggestive of a thrombus in a healthy distal ascending aorta (Fig. 1, Additional file 1: Video 1). Further investigations, inc
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