© 2014 Wiley Periodicals, Inc.
382
IMAGES
IN
CARDIAC SURGERY _____________________________________________________
Floating Thrombus in the Aortic Arch with Systemic Arterial Embolization Pierre-Luc Bernier, M.D., M.P.H., Mazin Fatani, M.D., Gordan Samoukovic, M.D., Tomas Huber, M.D., and Christo I. Tchervenkov, M.D. Division of Cardiac Surgery, Department of Surgery, McGill University Health Center, Montreal, Canada
doi: 10.1111/jocs.12281 (J Card Surg 2014;29:382) CASE A 48-year-old male underwent emergent bilateral aorto-iliac embolectomy for acute leg pain and was found on chest computed tomography (CT) to have a 4.5-cm mass in the proximal ascending aorta (Fig. 1). The patient was taken to the operating room and placed on cardiopulmonary bypass through the femoral artery and right atrium. During a brief period of hypothermic circulatory arrest, the mass was noted to
Figure 1. Coronal cut of the CT scan demonstrating the nearly occlusive mass within the ascending aorta and proximal aortic arch.
Conflict of interest: The authors acknowledge no conflict of interest in the submission. Address of correspondence: Pierre-Luc Bernier, M.D., M.P.H., Cardiovascular Surgery, The Montreal Children’s Hospital, 2300 Tupper Street, Room C8-29, Montreal, Canada H3H 1P3. Fax: þ1514-412-4400; e-mail: [email protected]
be attached to the posterior aspect of the aorta just above the sinotubular junction and extended to the proximal aortic arch (Fig. 2). This area was resected and continuity was restored with a 24-mm Gelweave interpostion graft (Vascutek-Terumo, Ann Arbor, MI, USA). The patient had an uncomplicated postoperative course and remains symptom free on aspirin and coumadin. The histology showed an organized thrombus without any pathological changes in the aortic wall.
Figure 2. Gross pathological specimen demonstrating the large size of the mass and its nonuniformly rough surface indicative of prior partial embolization.
382
IMAGES
IN
CARDIAC SURGERY _____________________________________________________
Floating Thrombus in the Aortic Arch with Systemic Arterial Embolization Pierre-Luc Bernier, M.D., M.P.H., Mazin Fatani, M.D., Gordan Samoukovic, M.D., Tomas Huber, M.D., and Christo I. Tchervenkov, M.D. Division of Cardiac Surgery, Department of Surgery, McGill University Health Center, Montreal, Canada
doi: 10.1111/jocs.12281 (J Card Surg 2014;29:382) CASE A 48-year-old male underwent emergent bilateral aorto-iliac embolectomy for acute leg pain and was found on chest computed tomography (CT) to have a 4.5-cm mass in the proximal ascending aorta (Fig. 1). The patient was taken to the operating room and placed on cardiopulmonary bypass through the femoral artery and right atrium. During a brief period of hypothermic circulatory arrest, the mass was noted to
Figure 1. Coronal cut of the CT scan demonstrating the nearly occlusive mass within the ascending aorta and proximal aortic arch.
Conflict of interest: The authors acknowledge no conflict of interest in the submission. Address of correspondence: Pierre-Luc Bernier, M.D., M.P.H., Cardiovascular Surgery, The Montreal Children’s Hospital, 2300 Tupper Street, Room C8-29, Montreal, Canada H3H 1P3. Fax: þ1514-412-4400; e-mail: [email protected]
be attached to the posterior aspect of the aorta just above the sinotubular junction and extended to the proximal aortic arch (Fig. 2). This area was resected and continuity was restored with a 24-mm Gelweave interpostion graft (Vascutek-Terumo, Ann Arbor, MI, USA). The patient had an uncomplicated postoperative course and remains symptom free on aspirin and coumadin. The histology showed an organized thrombus without any pathological changes in the aortic wall.
Figure 2. Gross pathological specimen demonstrating the large size of the mass and its nonuniformly rough surface indicative of prior partial embolization.
