A Mobile Thrombus in the Aortic Arch

Shinji Kawaguchi＊	Yuta Miyano＊	Shinnosuke Goto＊
Yasuhiko Terai＊	Ryota Nomura＊	Masanao Nakai＊
Hiroshi Mitsuoka＊	Fumio Yamazaki＊

（Department of Cardiovascular Surgery, Shizuoka City Hospital＊, Shizuoka, Japan）

A 51-year-old man was referred to our hospital with pain and coldness of the upper left extremity. Contrasted computed tomography revealed a silhouette protruding into the aortic arch. Peripheral embolism in upper left extremity by tumor or thrombosis was suspected. Magnetic resonance imaging revealed a mobile mass in the aortic arch. To prevent recurrent embolization, the mass and the aortic arch to which the mass was attached were excised and partial arch replacement was performed under cardiopulmonary bypass. Histologically, the mass was a fibrin thrombus with no malignancy. The aortic wall showed only mild atherosclerosis of the intima. No thrombotic predisposition such as protein S or C deficiency or antiphospholipid antibody syndrome was observed. Anticoagulant therapy was started and the patient was discharged on postoperative day 10 without recurrent thromboembolism. Three years have passed since the operation and there is no recurrence of thromboembolism.

 

Jpn. J. Cardiovasc. Surg. 50:57-60（2021）

Keywords：aorta thrombus;thrombectomy;anticoagulant therapy