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Ann Thorac Surg 2002;74:588-590
© 2002 The Society of Thoracic Surgeons

Case report

Floating nonocclusive thrombus in the ascending aorta

Ralf Sodian, MD*a, Matthias Bauer, MDa, Yu-Guo Weng, MD, PhDa, Hendrik Siniawski, MDa, Andreas Koster, MDa, Roland Hetzer, MD, PhDa

a Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany

Accepted for publication March 14, 2002.

* Address reprint requests to Dr Sodian, Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
e-mail: sodian{at}dhzb.de

We report the case of a 55-year-old woman seen with signs of angina pectoris and dyspnea. Transesophageal echocardiography showed a floating thrombus distal to the right coronary ostium. At operation, we found a highly mobile thrombus attached to an atherosclerotic plaque distal to the right coronary ostium. The atherosclerotic lesion and the pedunculated thrombotic mass were removed without resection of the adjacent aortic wall. In our judgment, a floating mass in the ascending aorta represents an emergency and should be removed before major thromboembolic complications occur.




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