Incidentally Found Ascending Aortic Thrombus

Quach, Nicolas; Medina, Marcelo Gabriel; Burton, Élan

doi:10.1016/j.jaccas.2021.07.027

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…20 We chose the first three months after starting oral anticoagulation to investigate a short-term effect and considered the highest therapeutic importance, based on previous research and also for patient convenience. [17][18][19][20][21][22][23] Our results suggest that a shorter duration would have been ineffective, and a longer duration would have had increase the chances of systemic embolism.…”

Section: Discussionmentioning

confidence: 71%

“…14 PTMC after complete clearance of LAA thrombus with oral anticoagulation minimizes the chances of thromboembolic events. 15,16 Although thrombus clearance has been reported with long-term oral anticoagulation, [17][18][19][20][21][22][23] the clinically significant consequence of short-term anticoagulation has not being documented earlier and is not well established. http://www.…”

Section: Discussionmentioning

confidence: 99%

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Resolution of Left Atrial Thrombus in Severe Mitral Stenosis Patients After Three Months of Anticoagulation

et al. 2022

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Objectives: To determine frequency of LA clot resolution in patients with severe MS after three months of anticoagulation. Methodology: A descriptive study was conducted over 6 months from Jul 2018 to Jan 2019 including 49 patients who fulfilled the inclusion criteria and visited Cardiology department, NICVD Hospital-Karachi. After clinical evaluation, warfarin therapy was given for 3 months followed by Transesophageal echocardiography (TEE) to access the resolution of LA thrombus. Chi-square test and Fisher Exact test were used to assess the effect of patient characteristics and echocardiographic findings on the resolution of thrombus. Results: The mean age of the study patients was 47.51±9.93 years. The average mitral valve area (cm2) was observed to be 0.68±0.16, while the average size of left atrial (mm) was 54.38±7.19. At the end of 2 months, TEE showed successful resolution of clot in 11 (22.4%). While by the end of 3 months, only 6 (12.2%) patients showed successful resolution of clot. Conclusion: After 3 months of oral anticoagulation, the LA thrombus resolved in almost 1/4th of the study patients. Successful clot resolution showed positive correlation with history of stroke, hemoptysis and clot mobility and negative correlation with severity of tricuspid regurgitation.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Resolution of Left Atrial Thrombus in Severe Mitral Stenosis Patients After Three Months of Anticoagulation

et al. 2022

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“…Thrombectomy is often performed for pedunculated aortic mural thrombus 23–25. In the present case, thrombectomy was performed because of the high risk of recurrent embolism even under anticoagulation therapy.…”

Section: Discussionmentioning

confidence: 87%

“…In the present case, thrombectomy was performed because of the high risk of recurrent embolism even under anticoagulation therapy. A surgical approach is preferable if the location, mobility, and stemness of the thrombus suggest a high risk of embolic events 24 25. Therefore, early surgical treatment can be a helpful option for aortic mural thrombus.…”

Section: Discussionmentioning

confidence: 99%

A floating mural thrombus in the ascending aorta can cause multiorgan infarction

Hirata

Tago²,

Nakashima³

et al. 2022

BMJ Case Rep

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A man in his 50s with sudden-onset left-sided subcostal pain was diagnosed with splenic infarction by thoracoabdominal CT with contrast enhancement, which also revealed a mural thrombus in the thoracoabdominal aorta, raising the possibility of aortic dissection. The electrocardiographic findings were normal and transthoracic echocardiography did not detect thrombus in the heart. Antihypertensive medication was administered on admission, and anticoagulation therapy was started after he developed left renal infarction and occlusion of the superior mesenteric artery. Nevertheless, he subsequently sustained an acute cerebral infarction. Transoesophageal echocardiography revealed an abnormal floating structure in the ascending aorta, which was surgically removed and finally diagnosed as an organising thrombus. Although most of the causes of multiorgan infarction are cardiogenic, floating mural thrombus can also be a cause. Anticoagulation therapy may be necessary for patients with recurring severe embolisms even when aortic dissection has not been completely ruled out.

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“…It could be due to proper aorta alterations (atherosclerosis and aortic dissection) or systemic alterations such as prothrombotic states, collagenopathies, and even hormonal disorders. [3][4][5] In lupus patients such as the case, the accelerated atherosclerotic process, and prothrombotic state favored the appearance of a giant thrombus in the aortic arch. 6 The most common clinical presentation is embolic events to extremities (84%).…”

Section: Discussionmentioning

confidence: 99%

In vivo exclusion of giant aortic thrombus

et al. 2022

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We present the case of a 53‐year‐old patient with a giant floating thrombus in the aortic arch associated with proximal stenosis of the left subclavian artery diagnosed by multimodal imaging. Left carotid‐subclavian shunt and thoracic endovascular aortic repair (TEVAR) were successful. Transesophageal echocardiography (TEE) played a substantial role in the safety and efficacy of the endovascular procedure and should be considered as an additional guide to fluoroscopy for this type of procedure.

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Incidentally Found Ascending Aortic Thrombus

Cited by 13 publications

References 9 publications

Resolution of Left Atrial Thrombus in Severe Mitral Stenosis Patients After Three Months of Anticoagulation

Resolution of Left Atrial Thrombus in Severe Mitral Stenosis Patients After Three Months of Anticoagulation

A floating mural thrombus in the ascending aorta can cause multiorgan infarction

In vivo exclusion of giant aortic thrombus

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