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Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
Multiorgan emboli due to an intraluminal thrombus from frozen elephant trunk
Yuki Imamura1, Ryosuke Kowatari1, Kazuyuki Daitoku1
1Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan.
Abstract:
The impact of kinking of the nonstented part of a frozen elephant trunk on the development of adverse effects is unclear. We report a case of an infected thrombus within the kinked nonstented portion of the frozen elephant trunk that resulted in multiorgan embolization. A 45-year-old man presented with a 1-month history of high-grade fever and fatigue. He had undergone emergent total arch replacement and frozen elephant trunk implantation for type A acute aortic dissection 7 years previously. Computed tomography showed an intraluminal thrombus within the kinked nonstented portion of the frozen elephant trunk. An autopsy also showed an intraluminal thrombus within the graft and diffuse microembolization in the abdominal organs. Therefore, in this case, kinking of the nonstented part of the frozen elephant trunk had resulted in an infected intraluminal thrombus, which subsequently caused multiorgan embolization.
Insights
Kinking of the nonstented frozen elephant trunk can lead to infected thrombus formation. This complication resulted in multiorgan embolization in a patient with a history of acute aortic dissection.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Medical Case Reports
Background:
- Frozen elephant trunk (FET) prostheses are used for aortic dissection repair.
- The nonstented portion of FETs can kink, but its clinical impact is poorly understood.
- Adverse events associated with FET kinking require further investigation.
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