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

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.