CC BY 4.0 · Aorta (Stamford) 2024; 12(05): 117-121
DOI: 10.1055/a-2536-4259
Case Report

Urgent Removal of a Mobile Mass in the Ascending Aorta under Hypothermic Circulatory Arrest in a Patient with Acute Stroke: A Case Report

Jenna E. Aziz
1   Department of Surgery, Ohio State University Medical Center, Columbus, Ohio
,
Jesica Zvara
2   Department of Anesthesia, George Washington University, Washington, District of Columbia
,
Cathy Burger
3   Division of Neurology, George Washington University, Washington, District of Columbia
,
Shawn Sarin
4   Department of Radiology, George Washington University, Washington, District of Columbia
,
5   Divison of Cardiac Surgery, George Washington University, Washington, District of Columbia
› Author Affiliations
Funding None.


Abstract

A mobile mass in the ascending aorta is a rare cause for stroke. Detection is usually accomplished by Computed tomography angiography and/or echocardiography. In suitable patients, urgent surgical removal remains the best approach.



Publication History

Received: 15 January 2025

Accepted: 10 February 2025

Article published online:
08 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Gouëffic Y, Chaillou P, Pillet JC, Duveau D, Patra P. Surgical treatment of nonaneurysmal aortic arch lesions in patients with systemic embolization. J Vasc Surg 2002; 36 (06) 1186-1193
  • 2 Kolvekar SK, Chaubey S, Firmin R. Floating thrombus in the aorta. Ann Thorac Surg 2001; 72 (03) 925-927
  • 3 Lyden PD, Zivin JA. Hemorrhagic transformation after cerebral ischemia: mechanisms and incidence. Cerebrovasc Brain Metab Rev 1993; 5 (01) 1-16
  • 4 Calderon P, Heredero A, Pastor A. et al. Successful removal of a floating thrombus in ascending aorta. Ann Thorac Surg 2011; 91 (05) e67-e69
  • 5 Campbell BCV, Khatri P. Stroke. Lancet 2020; 396 (10244): 129-142
  • 6 Hausmann D, Gulba D, Bargheer K, Niedermeyer J, Comess KA, Daniel WG. Successful thrombolysis of an aortic-arch thrombus in a patient after mesenteric embolism. N Engl J Med 1992; 327 (07) 500-501
  • 7 Kalangos A, Vala D, Bednarkiewicz M, Faidutti B. Technical implications regarding surgical removal of a floating thrombus located in the ascending aorta or aortic arch. Ann Vasc Surg 1999; 13 (01) 115-120
  • 8 Wang X, Lo EH. Triggers and mediators of hemorrhagic transformation in cerebral ischemia. Mol Neurobiol 2003; 28 (03) 229-244
  • 9 Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg 1995; 110 (06) 1745-1755
  • 10 Bhattacharyya S, Oo A. Timing of surgery after secondary embolic events in infective endocarditis. Ann Cardiothorac Surg 2019; 8 (06) 688-690
  • 11 Piper C, Wiemer M, Schulte HD, Horstkotte D. Stroke is not a contraindication for urgent valve replacement in acute infective endocarditis. J Heart Valve Dis 2001; 10 (06) 703-711
  • 12 Walther T, Mochalski M, Falk V, Mohr FW. Resection of a thrombus floating in the aortic arch. Ann Thorac Surg 1996; 62 (03) 899-901
  • 13 Ziganshin BA, Elefteriades JA. Deep hypothermic circulatory arrest. Ann Cardiothorac Surg 2013; 2 (03) 303-315