Cardiology Division, Spedali Riuniti, Livorno, Italy.
J Am Soc Echocardiogr. 2009 Oct;22(10):1197.e5-7. doi: 10.1016/j.echo.2009.04.017.
Aortic mural thrombosis is generally associated with several diseases, including coagulopathies, aortic dissection or trauma, tumors, and complicated atherosclerotic plaques. The development of a friable mobile thrombus, especially in the ascending aorta or proximal aortic arch, is a rare event with potentially ominous consequences because of a life-threatening risk of stroke and peripheral embolization. The treatment of choice of this condition is still controversial. We report a case of an absolutely asymptomatic 57-year-old patient with a mobile, pedunculated mass attached to the posterior wall of an otherwise normal ascending aorta. The aortic mass, identified by transthoracic echocardiography, was surgically removed and demonstrated to be a thrombus, and the aortic wall specimen was microscopically normal.
主动脉壁血栓形成通常与多种疾病相关，包括凝血障碍、主动脉夹层或创伤、肿瘤以及复杂的粥样硬化斑块。易碎的活动性血栓的形成，特别是在升主动脉或主动脉弓近端，是一种罕见的事件，具有潜在的严重后果，因为有发生中风和外周栓塞的致命风险。这种情况的治疗选择仍然存在争议。我们报告了一例 57 岁的绝对无症状患者，其升主动脉的后壁附着有一个活动性的、带蒂的肿块。经胸超声心动图发现的主动脉肿块被手术切除，证实为血栓，主动脉壁标本显微镜下正常。
