Thoracic aortic thrombi are a well-known cause of distal embolic phenomena. There is a paucity of case reports because of the rarity of this condition, and thus clear management guidelines are lacking. The authors present a case of a mobile thoracic aortic thrombus managed by a surgical approach. This report demonstrates how intraoperative transesophageal echocardiography (TEE) proved to be critical in guiding surgical management. The utility of TEE in the diagnosis and management of aortic thrombi is also discussed. In addition, currently reported management strategies for this complex condition are reviewed.
GiovanniNDanielaMGiovanniM. Endovascular treatment of thoracic aortic floating thrombus in patients presenting with acute lower limb ischemia. Int J Vasc Med. 2011;2011:604362. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034922/. Accessed June 23, 2011.
2.
MartensTVan HerzeeleIJacobsBDe RyckFRandonCVermassenF. Treatment of symptomatic mobile aortic thrombus. Acta Chir Belg. 2010;110:361-364.
3.
ChoukrounEMLabrousseLMMadonnaFPDevilleC. Mobile thrombus of the thoracic aorta: diagnosis and treatment in 9 cases. Ann Vasc Surg. 2002;16:714-722.
4.
LaraudogoitiaEEvangelistaAGarcía del CastilloH. Thrombus in the thoracic aorta as cause of peripheral embolism diagnosed using transesophageal echocardiography [in Spanish]. Rev Esp Cardiol. 1997;50:60-64.
5.
LozanoPGomezFTJuliaJM-RimbauEGarciaF. Recurrent embolism caused by floating thrombus in the thoracic aorta. Ann Vasc Surg. 1998;12:609-611.
6.
WolfPSBurmanHEStarnesBW. Endovascular treatment of massive thoracic aortic thrombus and associated ruptured atheroma. Ann Vasc Surg. 2010;24:416.e9-416.e12.
7.
ProthetJFloccardBLevratA. Recurrent systemic embolism: look for a thrombus in . . . the thoracic aorta [in French]. Ann Fr Anesth Reanim. 2008;27:723-726.
8.
CriadoEWallPLucasPGasparisAProffitTRicottaJ. Transesophageal echo-guided endovascular exclusion of thoracic aortic mobile thrombi. J Vasc Surg. 2004;39:238-242.
