Department of Cardiovascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, Zhejiang, 310003, China.
School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
J Cardiothorac Surg. 2021 Jul 23;16(1):200. doi: 10.1186/s13019-021-01585-w.
The mural thrombus in the ascending aorta is rare, most of which are associated with aneurysm or atherosclerotic lesions, with high risks of causing catastrophic thrombotic events. A mural thrombus in the non-aneurysmal and non-atherosclerotic ascending aorta is exceptionally uncommon.
We reported a large mural thrombus in normal ascending aorta of an asymptomatic patient. Preoperative imaging confirmed the presence of the sessile thrombus located at the left anterior wall of ascending aorta. Given that it had the potential to cause fatal thrombotic complications, surgical removal and segment of ascending aorta replacement were executed. The patient had an uneventful recovery and discharged 14 days after surgery.
Anticoagulant is the therapeutic cornerstone of ascending aortic thrombus, but surgery should be performed aggressively when the thrombus is large or floating to avoid severe embolic complications or recurrence.
升主动脉壁血栓较为罕见，多数与动脉瘤或粥样硬化病变相关，有发生灾难性血栓事件的高风险。非动脉瘤性和非粥样硬化性升主动脉壁血栓极为罕见。
我们报告了一例无症状患者正常升主动脉内的巨大壁血栓。术前影像学检查证实了位于升主动左前壁的附壁血栓的存在。鉴于其有引发致命性血栓并发症的可能，我们实施了手术切除和升主动脉节段置换。患者术后恢复顺利，术后 14 天出院。
抗凝是升主动脉血栓的治疗基石，但当血栓较大或漂浮时，应积极进行手术，以避免严重的栓塞并发症或复发。
