Floating thrombus of the ascending aorta after treatment of ureteral carcinoma: A case report

Andrei George Iosifescu

doi:10.5606/tgkdc.dergisi.2022.23181

Andrei George Iosifescu^1,2, Corina Radu¹, Simona Laura Marin³, Roxana Enache^2,4

¹Department of Cardiac Surgery, Constantin Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
²University of Medicine and Pharmacy Carol Davila, Faculty of General Medicine, Bucharest, Romania
³Department of Cardiac Anesthesia and Intensive Care, Constantin Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
⁴Department of Cardiology, Constantin Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

DOI : 10.5606/tgkdc.dergisi.2022.23181

An asymptomatic 59-year-old female patient presented with a large floating mass, presumably a thrombus, in the distal ascending aorta. It developed during chemotherapy following nephrectomy for ureteral carcinoma. Due to embolic risks, surgery was indicated. Epiaortic echography revealed embolic risks upon aortic cross-clamping. Aortotomy was performed during brief circulatory arrest under mild hypothermia, followed by safe aortic cross-clamping under direct vision and aortic thrombectomy. The postoperative course was uneventful. Malignancy- and chemotherapy-induced hypercoagulation probably favored thrombus formation. In conclusion, epiaortic echography and short circulatory arrest under tepid hypothermia help to avoid embolic events during ascending aorta thrombectomy.

Keywords : Aorta, aortic surgery, cancer chemotherapy, circulatory arrest, epiaortic echography, floating thrombus

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