Sadony V, Walz M, Löhr E, Rimpel J, Richter H J
Department of Thoracic and Cardiovascular Surgery, University of Essen, Federal Republic of Germany.
Eur J Cardiothorac Surg. 1988;2(6):469-71. doi: 10.1016/1010-7940(88)90054-1.
A 46-year-old fully active, asymptomatic man suffered two episodes of major peripheral arterial embolism within 2 months. Heart disease was ruled out by appropriate investigations. Further diagnostic evaluation (angiography, CAT scan) revealed the extremely rare finding of a "floating mass" in the transverse aortic arch suspected to be the source of embolization. This mass was successfully removed using the technique of hypothermic cardiocirculatory arrest. The histological diagnosis was an aged intraluminal thrombus and moderate atherosclerosis of the thoracic aorta. For prevention of recurrent arterial embolism in cases without an initially apparent cause and site of origin, a thorough diagnostic, and in a given patient, an aggressive surgical approach for the elimination of the embolic source are advocated.
一名46岁完全活跃、无症状的男性在2个月内发生了两次严重的外周动脉栓塞事件。通过适当检查排除了心脏病。进一步的诊断评估（血管造影、计算机断层扫描）发现，在横位主动脉弓处有一个极为罕见的“漂浮肿块”，怀疑是栓塞的来源。采用低温心脏循环停止技术成功切除了该肿块。组织学诊断为陈旧性腔内血栓形成和胸主动脉中度动脉粥样硬化。对于无明显初始病因和起源部位的复发性动脉栓塞病例，提倡进行全面诊断，并针对特定患者采取积极的手术方法以消除栓子来源。
