Gueldich Majdi, Piscitelli Mariantonietta, Derbel Haytham, Boughanmi Khaoula, Bergoend Eric, Chanai Nora, Folliguet Thierry, Fiore Antonio
Department of Cardiac Surgery, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Department of Medical Imaging, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Interact Cardiovasc Thorac Surg. 2020 May 1;30(5):762-764. doi: 10.1093/icvts/ivaa017.
A floating thrombus in the ascending aorta is rarely found in clinical practice and is an uncommon cause of peripheral arterial embolization. When there is minimal atherosclerosis or a normal aorta, the management of such a lesion is poorly defined. Currently, there is no clear consensus concerning optimal treatment. Herein, we report 2 cases of ascending aortic thrombus that are complicated by a peripheral embolic event. Due to the risk of recurrent systemic embolism, particularly with strokes, surgical thrombectomy with ascending aortic wall replacements was performed. We believe that floating ascending aorta thrombus represents a serious source of systemic embolism and stroke. Surgical removal is easy to perform with good clinical outcomes. Conservative treatments such as anticoagulation or thromboaspiration may be considered in high-risk or inoperable patients.
升主动脉浮动血栓在临床实践中很少见，是外周动脉栓塞的罕见原因。当动脉粥样硬化程度较轻或主动脉正常时，此类病变的处理方法尚不明确。目前，关于最佳治疗方案尚无明确共识。在此，我们报告2例升主动脉血栓合并外周栓塞事件的病例。由于存在反复发生全身栓塞的风险，尤其是中风风险，因此实施了升主动脉壁置换术联合手术取栓。我们认为，升主动脉浮动血栓是全身栓塞和中风的严重来源。手术切除操作简便，临床效果良好。对于高危或无法手术的患者，可考虑抗凝或血栓抽吸等保守治疗。
