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Eur J Cardiothorac Surg 2001;19:534-536
© 2001 Elsevier Science NL

Case report

Thrombotic formations within the aortic arch as source of embolization in patients with coagulopathia

Department of Cardiovascular and Thoracic Surgery, Kerckhoff Clinic Foundation, Bad Nauheim, Germany

Received 30 November 2000; received in revised form 17 February 2001; accepted 20 February 2001.

Corresponding author. Tel.: +49-6032-996-2502; fax: +49-6032-996-2567
e-mail: matthias.roth{at}kerckhoff.med.uni-giessen.de

Thrombotic formations on atherosclerotic lesions of the thoracic aorta are potential sources of cerebral and systemic embolization. Especially younger patients without calcifications of atherosclerotic plaques or coagulation disorders have a higher risk for embolization. Magnetic resonance imaging and transesophageal echocardiography are the diagnostic methods of choice. As an alternative to anticoagulation surgical therapy is indicated to prevent severe brain damage or multiorgane failure in patients with mobile thrombotic formations. Herein we describe two patients in whom successful surgical treatment was performed in deep hypothermic circulatory arrest by excision of the aortic arch atheroma.

Key Words: Thrombosis • Aortic arch