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Case Reports
. 2021 Oct 28;57(11):1176.
doi: 10.3390/medicina57111176.

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction-Case Report

Horațiu Moldovan  1   2 , Cristian Bulescu  1 , Andra-Mădălina Sibișan  2 , Robert Țigănașu  2 , Cătălin Cacoveanu  2 , Claudia Nica  2 , Andreea Rachieru  3 , Daniela Gheorghiță  4 , Ondin Zaharia  1   5 , Șerban Bălănescu  1 , Alexandru Scafa-Udriște  1   2
Affiliations
Case Reports

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction-Case Report

Horațiu Moldovan et al. Medicina (Kaunas). .

Abstract

We present the case of a 50-year-old male, with no cardiovascular risk factors other than smoking, that presented with acute chest pain, revealed to be an acute myocardial infarction with a large thrombus located in the ascending aorta. Such findings are rare in a patient with no other afflictions, such as atherosclerosis, aortic aneurysm, or aortic wall injury (surgical or traumatic). There is no specific pathway regarding the management of ascending aorta thrombus in such a patient; therapeutic options include surgical, interventional, or medical methods. Surgical thrombectomy was performed in this case, considering the high risk of systemic embolism and stroke and the hemodynamic stability of the patient.

Keywords: acute myocardial infarction; ascending aorta; large thrombus; surgical thrombectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) (standard limb leads) and (B) (standard precordial leads). Emergency room 12-Lead ECG presenting an inferior myocardial infarction, ST-T segment elevation.
Figure 2
Figure 2
(A,B). 3D reconstruction of CTA(computed tomography angiography) image of the ascending aorta. Filling defect in the ascending aorta (blue arrow). Right coronary artery (orange arrow). Left coronary artery (green arrow).
Figure 3
Figure 3
(A,B). CTA showing endoluminal aortic thrombus (filling defect in the ascending aorta—blue arrow).
Figure 4
Figure 4
(A) (thrombus—orange arrow) and (B) (aortic root and thrombus). Emergency room transesophageal echocardiography showing the floating thrombus located in the ascending aorta.
Figure 5
Figure 5
CTA image showing right coronary artery obstruction (yellow arrow) and the endoluminal thrombus (filling defect in the ascending aorta—green arrow).
Figure 6
Figure 6
(A) (close-up image of the thrombus) and (B) (size referencing) intraoperative aspect of the removed thrombus.
Figure 7
Figure 7
Postoperative chest X-ray.
Figure 8
Figure 8
(A–C) (different sections of the same sample). Microscopic aspect of the thrombus (fibrin and white and red blood cells).
See this image and copyright information in PMC

References

    1. Cañadas V., Vilacosta I., Luaces M., Bustos A., Ferreirós J., Aragoncillo P., Pérez de Isla L., Rodríguez E. Trombosis en aorta torácica aparentemente normal y embolias arteriales [Thrombosis of an apparently normal thoracic aorta and arterial embolism] Rev. Esp. Cardiol. 2008;61:196–200. doi: 10.1157/13116207. - DOI - PubMed
    1. Ford S.E., Ford P.M. The cardiovascular pathology of anti-phospholipid antibodies: An illustrative case and review of the literature. Cardiovasc. Pathol. 1995;4:111–122. doi: 10.1016/1054-8807(94)00044-R. - DOI - PubMed
    1. McGee G.S., Pearce W.H., Sharma L., Green D., Yao J.S.T. Antiphospholipid Antibodies and Arterial Thrombosis. Arch. Surg. 1992;127:342–346. doi: 10.1001/archsurg.1992.01420030116022. - DOI - PubMed
    1. Wang B., Ma D., Cao D., Man X. Huge thrombus in the ascending aorta: A case report and literature review. J. Cardiothorac. Surg. 2019;14:1–4. doi: 10.1186/s13019-019-0975-y. - DOI - PMC - PubMed
    1. Neumann F.-J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U., Byrne A.R., Collet J.-P., Falk V. Ghidul privind revascularizarea miocardică ESC/EACTS 2018. Rom. J. Cardiol. 2019;29:281–286.

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