Namura Osamu, Sogawa Masakazu, Asami Fuyuki, Okamoto Takeshi, Hanzawa Kazuhiko, Hayashi Jun-ichi
Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
Gen Thorac Cardiovasc Surg. 2011 Sep;59(9):612-5. doi: 10.1007/s11748-010-0752-2. Epub 2011 Sep 14.
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.
我们报告一例54岁男性患者，其左腿急性动脉闭塞，栓子源自几乎正常的胸主动脉，为漂浮血栓。经食管超声心动图（TEE）、计算机断层扫描和磁共振成像显示，在急性动脉闭塞行取栓术后，几乎正常的主动脉内有两个肿块。尽管组织学检查栓子为血栓，但不能排除恶性肿瘤。抗凝治疗7天后肿块大小未减小，因此在体外循环（CPB）和TEE引导下将其切除。CPB期间的冰冻切片检查表明，切除的肿块无恶性证据。TEE在该疾病的诊断和手术中发挥了重要作用，在决定手术策略时很有用。由于该疾病的治疗策略仍存在争议，需要进一步研究。
