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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...

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Autores principales: Li, Guanhua, Chen, Yingzhen, Wang, Haikuo, Liu, Yanping, Liu, Hangyu, Sun, He, Wang, Zhiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996118/
https://www.ncbi.nlm.nih.gov/pubmed/36910530
http://dx.doi.org/10.3389/fcvm.2023.1091303
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author Li, Guanhua
Chen, Yingzhen
Wang, Haikuo
Liu, Yanping
Liu, Hangyu
Sun, He
Wang, Zhiping
author_facet Li, Guanhua
Chen, Yingzhen
Wang, Haikuo
Liu, Yanping
Liu, Hangyu
Sun, He
Wang, Zhiping
author_sort Li, Guanhua
collection PubMed
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.
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spelling pubmed-99961182023-03-10 Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch Li, Guanhua Chen, Yingzhen Wang, Haikuo Liu, Yanping Liu, Hangyu Sun, He Wang, Zhiping Front Cardiovasc Med Cardiovascular Medicine 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. Frontiers Media S.A. 2023-02-24 /pmc/articles/PMC9996118/ /pubmed/36910530 http://dx.doi.org/10.3389/fcvm.2023.1091303 Text en Copyright © 2023 Li, Chen, Wang, Liu, Liu, Sun and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Li, Guanhua
Chen, Yingzhen
Wang, Haikuo
Liu, Yanping
Liu, Hangyu
Sun, He
Wang, Zhiping
Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch
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 Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996118/
https://www.ncbi.nlm.nih.gov/pubmed/36910530
http://dx.doi.org/10.3389/fcvm.2023.1091303
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