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[A case of protruding atherosclerotic plaque with mobile projections in the sino-tubular junction]

J Hirota1, K Akiyama, N Taniyasu

  • 1Department of Cardiovascular Surgery, Iwaki Kyoritsu General Hospital, Iwaki, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|November 20, 2001
PubMed

Insights

A mobile atherosclerotic plaque with thrombi in the aortic root caused ischemic stroke and emboli in a hemodialysis patient. Surgical removal and intraoperative transesophageal echocardiography were key to management.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Nephrology

Background:

  • Atherosclerotic plaque in the aortic root can lead to serious embolic events.
  • Patients undergoing long-term hemodialysis are at increased risk for cardiovascular complications.

Observation:

  • A 66-year-old woman on maintenance hemodialysis presented with ischemic stroke and systemic emboli.
  • Transthoracic echocardiography revealed large, mobile atherosclerotic plaques with thrombi in the aortic root.
  • The plaques originated from the posterior ascending aorta at the sinus of Valsalva.

Findings:

  • Surgical endarterectomy successfully removed the protruding aortic atheroma under cardiopulmonary bypass.
  • Pathologic examination confirmed atherosclerotic plaque with superimposed thrombi.
  • Transesophageal echocardiography proved valuable for intraoperative detection of the aortic atheroma.

Implications:

  • This case highlights the potential for aortic atheroma to cause embolic events in dialysis patients.
  • Early detection and surgical intervention are crucial for managing such conditions.
  • Transesophageal echocardiography is a useful tool for intraoperative assessment during aortic procedures.

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