Total Arch Replacement for Aortic Arch Thrombosis Combined with Severe Mitral Regurgitation

Masato Saitoh; Takuma Yamasaki; Tomoaki Tanabe; Shuichi Tochigi; Shoh Tatebe; Imun Tei

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Total Arch Replacement for Aortic Arch Thrombosis Combined with Severe Mitral Regurgitation

VernacularTitle:重症僧帽弁閉鎖不全症に併存した弓部大動脈内血栓症に対して弓部大動脈人工血管置換術を施行した1例
Author: Masato SAITOH ¹ ; Takuma YAMASAKI ¹ ; Tomoaki TANABE ¹ ; Shuichi TOCHIGI ¹ ; Shoh TATEBE ² ; Imun TEI ¹
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1. Department of Cardiovascular Surgery, Ayase Heart Hospital
2. Department of Cardiovascular Surgery, Ayase Heart Rehabilitation Hospital
Keywords: aortic thrombus; mitral regurgitation; fenestrated frozen elephant trunk technique
From:Japanese Journal of Cardiovascular Surgery 2024;53(3):131-135
CountryJapan
Language:Japanese
Abstract: A 74-year-old male with exertional breathlessness was referred to our hospital by his general physician. Echocardiography revealed severe mitral regurgitation. An aortic and coronary computed tomography scan revealed aortic arch thrombosis and coronary artery stenosis in the left anterior descending (LAD) artery. In consideration of the risk of embolization, the patient underwent emergency surgery on the same day. The surgical procedure involved the replacement of the aortic arch with a fenestrated frozen elephant trunk, mitral valvuloplasty, and coronary artery bypass graft for the LAD artery. Blood tests revealed no underlying coagulopathy. The patient did not develop any postoperative complications. He was discharged home on his own on postoperative day 19. One year after the surgery, no recurrence of thrombosis or heart failure was observed. Severe mitral regurgitation complicated with intraaortic thrombosis is rare. This case report indicates that intraaortic thrombosis can occur even in patients without any underlying blood coagulation abnormalities. We report this case with a review of the literature.