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Presentation transcript:

Thoracic Aortic Mobile Thrombus: Is There a Role for Early Surgical Intervention? Sebastian Pagni, MD, Jaimin Trivedi, MD, MPH, Brian L. Ganzel, MD, Matthew Williams, MD, Nick Kapoor, MD, Charles Ross, MD, A. David Slater, MD The Annals of Thoracic Surgery Volume 91, Issue 6, Pages 1875-1881 (June 2011) DOI: 10.1016/j.athoracsur.2011.02.011 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Transesophageal echocardiogram showing the proximal attachment of a mobile thrombus (red arrow) in the descending thoracic aorta. The Annals of Thoracic Surgery 2011 91, 1875-1881DOI: (10.1016/j.athoracsur.2011.02.011) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Computed tomography angiography showing a mid descending aortic thrombus (red arrow; sagittal reconstructed view). (B) Axial view on the same patient showing the pedunculated thrombus (red arrow). The Annals of Thoracic Surgery 2011 91, 1875-1881DOI: (10.1016/j.athoracsur.2011.02.011) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Locations of thrombi in the thoracic aorta, determined by transesophageal echocardiogram and computed tomography angiography, in 14 patients with thoracic aortic mobile thrombus. The Annals of Thoracic Surgery 2011 91, 1875-1881DOI: (10.1016/j.athoracsur.2011.02.011) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Patient 5, surgical view of the pedunculated thrombus anchored in the ductus fossette. The white arrows indicate the aortic walls, and the blue arrow indicates the intraaortic thrombus. (B) Left thoracotomy approach with upper and lower aortotomies for thrombi (2) removal using left atriofemoral partial bypass. (C) Surgical specimen from the same patient demonstrating partially organized thrombus with a fresh component (the scale of aortic diameter is augmented ×3). The Annals of Thoracic Surgery 2011 91, 1875-1881DOI: (10.1016/j.athoracsur.2011.02.011) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions