Surgical Treatment of a Large, Highly Mobile Atheroma in the Ascending Aorta

A 53-year-old woman diagnosed with chronic renal failure requiring homodyalisis, and Behcžet's disease was found, during a regular examination, having a large protruding mobile atheroma in the ascending aorta by transthoracic echocardiography. We performed surgery to remove the atheroma and localized debridement using moderate hypothermic circulatory arrest to prevent future stroke and embolism. She had an uneventful postoperative course.

Atheroma

References

• 1 Amarenco P, Cohen A, Tzourio C. et al . Atherosclerotic disease of the aortic arch and the risk of ischemic stroke.  N Engl J Med.. 1994;  331 1474-1479
• 2 Tunick P A, Rosenzweig B P, Katz E S, Freedberg R S, Perez J L, Kronzon I. High risk for vascular events in patients with protruding aortic atheromas: A prospective study.  J Am Coll Cardiol.. 1994;  23 1085-1090
• 3 Mitusch R, Doherty C, Wucherpfennig H. et al . Vascular events during follow-up in patients with aortic arch atherosclerosis.  Stroke.. 1997;  28 36-39
• 4 Tenenbaum A, Fisman E Z, Schneiderman J. et al . Disrupted mobile aortic plaques are a major risk factor for systemic embolism in the elderly.  Cardiology.. 1998;  89 246-251
• 5 Swanson S J, Cohn L H. Excision of focal aortic arch atheroma using deep hypothermic circulatory arrest.  Ann Thorac Surg.. 1995;  60 457-458
• 6 Bojay R M, Payne D D, Murphy R E. et al . Surgical treatment of systemic atheroembolism from the thoracic aorta.  Ann Thorac Surg.. 1996;  61 1389-1393
• 7 Dee W, Geibel A, Kasper W, Konatantinides S, Just H. Mobil thrombi in atherosclerotic lesions of the thoracic aorta: The diagnostic impact of transesophageal echocardiography.  Am Heart J.. 1993;  126 707-710
• 8 Laperche T, Laurian C, Roudaut R, Steg G. Mobile thromboses of the aortic arch without aortic debris. A transesophageal echocardiographic findings associated with unexplained arterial embolism.  Circulation.. 1997;  96 288-294
• 9 Koren M J, Bryant B. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke.  N Engl J Med.. 1995;  332 1237

Received for Publication: December 6,1999