Abstract
BackgroundThe 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.Case presentationWe 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.ConclusionsAnticoagulant 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.
Highlights
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
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
The mural thrombus in the ascending aorta(AA) is rare, most of which are associated with aneurysm or atherosclerotic lesions, with high risks of causing catastrophic thrombotic events, such as ischemic stroke, acute myocardial infarction and peripheral arterial embolism
Summary
The mural thrombus in the ascending aorta(AA) is rare, most of which are associated with aneurysm or atherosclerotic lesions, with high risks of causing catastrophic thrombotic events, such as ischemic stroke, acute myocardial infarction and peripheral arterial embolism. Extremity ultrasound confirmed deep vein thrombosis in his right lower limb, which was responsible for his suffering. He had a past history of massive pulmonary embolisms, which were reduced obviously after 5-month course of oral anticoagulant. Histopathological examination confirmed the mass was a white thrombus with intima exfoliation and no evidence of malignancy had been found. He had an uneventful recovery and discharged 14 days after surgery. Heparin and aspirin were applied as anticoagulant therapy during hospitalization, which changed to 3-month course of rivaroxaban when he was discharged
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