Conservative Treatment of a Floating Mural Thrombus in the Descending Aorta

Area of Science:

• Cardiovascular Surgery
• Vascular Medicine
• Thrombosis Research

Background:

• Floating mural thrombi in the aortic arch are rare and pose a risk of embolization.
• Diagnosis often involves advanced imaging techniques to assess thrombus characteristics and extent.
• Management strategies vary, with a need to balance anticoagulation risks against embolic events.

Purpose of the Study:

• To report a case of a large floating mural thrombus in the aortic arch.
• To evaluate the efficacy of anticoagulation therapy in resolving aortic mural thrombi.
• To highlight a successful non-operative management strategy for this condition.

Main Methods:

• A 70-year-old female patient presented with a floating mural thrombus.
• Diagnostic imaging confirmed thrombus location in the distal aortic arch and proximal descending aorta.
• Treatment initiated with aspirin and low-molecular-weight heparin.

Main Results:

• Clinical examination and imaging revealed no signs of embolization.
• Follow-up imaging at 2 weeks and 6 months demonstrated complete resolution of the aortic mural thrombus.
• The patient tolerated anticoagulation therapy without significant complications.

Conclusions:

• Anticoagulation therapy with aspirin and low-molecular-weight heparin can be an effective treatment for aortic mural thrombi.
• Non-operative management may be a viable option in select cases without evidence of embolization.
• Complete resolution of aortic mural thrombi is achievable, reducing the risk of future embolic events.