外科ジャーナル

Unexpected Outcome of a Floating Thrombus in the Ascending Aorta

Abstract

Hassane Abdallah, Pierre-Emmanuel Noly and Gebrine Elkhoury

We report the case of a 46-year-old woman, without any known systemic disease in the past, a history of car accident two months earlier with fracture of the left arm and the jaw. She presented to a local hospital, with prolonged precordial pain of ON/OFF occurrence, where acute coronary syndrome (ACS) was diagnosed and treated with conventional (aspirin, clopidegrel, β-blockers, heparin) treatment. She was then transferred to our hospital for cardiac catheterization. Coronary angiography showed normal coronary arteries, a moving filling defect was visible in the ascending aorta. An immediate transesophageal echocardiography revealed a free floating mass attached to the left cusp of the aortic valve .and occluding the left main coronary trunk, a trace of aortic valve regurgitation. The patient was hemodynamically unstable. Urgent operation was carried on and resection of the mass was done.