Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch
Large mural thrombi in the relatively normal ascending aorta are extremely uncommon conditions that may lead to major adverse cardiovascular events due to new embolism. Because of their changeable variations, the management of these unstable thrombi is challenging and controversial. The size, morpho...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1091303/full |
| _version_ | 1797896036256055296 |
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| author | Guanhua Li Yingzhen Chen Haikuo Wang Yanping Liu Hangyu Liu He Sun Zhiping Wang |
| author_facet | Guanhua Li Yingzhen Chen Haikuo Wang Yanping Liu Hangyu Liu He Sun Zhiping Wang |
| author_sort | Guanhua Li |
| collection | DOAJ |
| description | Large mural thrombi in the relatively normal ascending aorta are extremely uncommon conditions that may lead to major adverse cardiovascular events due to new embolism. Because of their changeable variations, the management of these unstable thrombi is challenging and controversial. The size, morphology, location, embolic involvement, and patients’ conditions are all crucial for therapeutic decision-making. Treatment options include anticoagulation, thrombolysis, surgical thrombectomy, and endovascular stenting. Therefore, surgical strategies should be highly individualized. Herein, we present a rare case of a huge thrombus from the ascending aorta to the arch in a 43-year-old man. Considering the high risks of catastrophic embolic events, surgical removal of the aortic mass, thromboendarterectomy, and reconstruction of the arterial wall were performed with a satisfactory outcome. This report illustrates our experience of surgical strategies and perioperative treatments for this challenging case, and contemporary surgical management for mural thrombi in the ascending aorta was also thoroughly discussed. |
| first_indexed | 2024-04-10T07:36:28Z |
| format | Article |
| id | doaj.art-2d69ce84751f4c308e0b795d7ad401ad |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T07:36:28Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-2d69ce84751f4c308e0b795d7ad401ad2023-02-23T12:41:05ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-02-011010.3389/fcvm.2023.10913031091303Case report: Surgical strategies of a giant thrombus from the ascending aorta to the archGuanhua Li0Yingzhen Chen1Haikuo Wang2Yanping Liu3Hangyu Liu4He Sun5Zhiping Wang6Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaLarge mural thrombi in the relatively normal ascending aorta are extremely uncommon conditions that may lead to major adverse cardiovascular events due to new embolism. Because of their changeable variations, the management of these unstable thrombi is challenging and controversial. The size, morphology, location, embolic involvement, and patients’ conditions are all crucial for therapeutic decision-making. Treatment options include anticoagulation, thrombolysis, surgical thrombectomy, and endovascular stenting. Therefore, surgical strategies should be highly individualized. Herein, we present a rare case of a huge thrombus from the ascending aorta to the arch in a 43-year-old man. Considering the high risks of catastrophic embolic events, surgical removal of the aortic mass, thromboendarterectomy, and reconstruction of the arterial wall were performed with a satisfactory outcome. This report illustrates our experience of surgical strategies and perioperative treatments for this challenging case, and contemporary surgical management for mural thrombi in the ascending aorta was also thoroughly discussed.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1091303/fullthrombusascending aortaaortic archsurgical strategiesdeep hypothermic circulatory arrest |
| spellingShingle | Guanhua Li Yingzhen Chen Haikuo Wang Yanping Liu Hangyu Liu He Sun Zhiping Wang Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch Frontiers in Cardiovascular Medicine thrombus ascending aorta aortic arch surgical strategies deep hypothermic circulatory arrest |
| title | Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch |
| title_full | Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch |
| title_fullStr | Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch |
| title_full_unstemmed | Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch |
| title_short | Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch |
| title_sort | case report surgical strategies of a giant thrombus from the ascending aorta to the arch |
| topic | thrombus ascending aorta aortic arch surgical strategies deep hypothermic circulatory arrest |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1091303/full |
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