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Eur J Cardiothorac Surg 2004;25:286
© 2004 Elsevier Science NL

Images in cardio-thoracic surgery

Ascending aortic thrombus causing stroke

Peter Matt*, Atanas Todorov, Martin Grapow, Hans-Reinhard Zerkowski

Division of Cardio-Thoracic Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland

Received 30 September 2003; received in revised form 11 November 2003; accepted 12 November 2003.

* Corresponding author. Tel.: +41-61-265-25-25; fax: +41-61-265-88-54
e-mail: pmatt{at}uhbs.ch

Key Words: Thrombus • Aortic surgery • Stroke

A 49-year-old man was admitted to our hospital due to a hemiparesis. Transesophageal echocardiography and three-dimensional computed tomography showed a mobile mass attached to the anterior wall of the ascending aorta (Fig. 1) . At surgery a pedunculated thrombus, originating from a small atherosclerotic lesion, was found 1.5 cm superior to the left coronary sinus (Fig. 2) .



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  		Fig. 1. Three-dimensional reconstructive computed tomography of the ascending aortic lumina. TR indicates thrombus; AA, anterior wall of the ascending aorta.

 


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  		Fig. 2. Intraoperative view through the aortotomy from cranial to the aortic valve. BT indicates base of thrombus; LCS, left coronary sinus.

 




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