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Severely Kinked Ascending Aorta Prosthetic Graft Causing Thromboembolism
Nesar A Hasami1, Guillaume S C Geuzebroek1, Tim Smith2
1Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
JACC. Case Reports
|July 11, 2025
Summary
A severely kinked aortic graft caused a late thromboembolic stroke in a patient with vascular Ehlers-Danlos syndrome. Vigilant surveillance is crucial for preventing such rare but severe aortic surgery complications.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Vascular Medicine
Background:
- Thromboembolic events post-aortic surgery are rare but serious.
- Vascular Ehlers-Danlos syndrome presents unique challenges in aortic disease management.
Observation:
- A case report details a late cerebellar stroke in a 43-year-old male 5 years after aortic dissection repair.
- Imaging revealed a thrombus in the ascending aorta and carotid artery, linked to a severely kinked prosthetic graft.
Findings:
- The kinked aortic prosthesis was identified as the source of thrombus formation.
- Thrombolysis resolved the initial clot, but new thrombi formed at the kink during subsequent surgery.
Implications:
- Prosthetic graft kinking poses a significant risk for thromboembolic events.
- Close patient monitoring and timely intervention are essential after aortic repair, especially in high-risk patients.
- This case underscores the need for careful graft placement and follow-up to mitigate risks.
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