Surgical Resection of a Symptomatic Ascending Aortic Mural Thrombus

Aortic mural thrombus (AMT) is a rare disease with an unclear optimal treatment strategy. AMT in the ascending aorta is particularly uncommon and is associated with the additional risk of embolization to the brain. Resection of an ascending AMT is particularly challenging given the high risk of thrombus dislodgment during aortic cannulation and cross-clamp application. This case demonstrates successful surgical resection of a symptomatic ascending AMT without the use of hypothermic circulatory arrest, with complete excision of the thrombus and replacement of the abnormal aorta using graft material.