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Case Reports
. 2022 Jul 29;30(3):444-447.
doi: 10.5606/tgkdc.dergisi.2022.23181. eCollection 2022 Jul.

Floating thrombus of the ascending aorta after treatment of ureteral carcinoma: A case report

Andrei George Iosifescu  1   2 , Corina Radu  1 , Simona Laura Marin  3 , Roxana Enache  2   4
Affiliations
Case Reports

Floating thrombus of the ascending aorta after treatment of ureteral carcinoma: A case report

Andrei George Iosifescu et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

An asymptomatic 59-year-old female patient presented with a large floating mass, presumably a thrombus, in the distal ascending aorta. It developed during chemotherapy following nephrectomy for ureteral carcinoma. Due to embolic risks, surgery was indicated. Epiaortic echography revealed embolic risks upon aortic cross-clamping. Aortotomy was performed during brief circulatory arrest under mild hypothermia, followed by safe aortic cross-clamping under direct vision and aortic thrombectomy. The postoperative course was uneventful. Malignancy- and chemotherapy-induced hypercoagulation probably favored thrombus formation. In conclusion, epiaortic echography and short circulatory arrest under tepid hypothermia help to avoid embolic events during ascending aorta thrombectomy.

Keywords: Aorta; aortic surgery; cancer chemotherapy; circulatory arrest; epiaortic echography; floating thrombus.

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Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. Contrast-enhanced computed tomography with multiplanar reconstruction demonstrating the floating thrombus of the ascending aorta.
Figure 2
Figure 2. Floating thrombus of the ascending aorta (arrow). (a) Two-dimensional transthoracic echocardiography (multiplanar transducer, suprasternal view). (b) Intraoperative epiaortic echography (transverse view of the ascending aorta at the most distal clamping level).
See this image and copyright information in PMC

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