Abstract
Aortic thrombosis without an atherosclerotic lesion is a rare disease that occasionally follows fatal embolism. We report the case of a 43-year-old man with acute myocardial infarction caused by right coronary artery ostial occlusion due to a large mobile thrombus in the ascending aorta. The patient was referred to our department with sudden chest pain during steroid replacement therapy after Hardy procedures. Angiography and contrast-enhanced computed tomography detected a large mass or flap in the ascending aorta. His coagulation tests were almost normal without D-dimer. We performed emergent surgery to remove a 5.6×1.8×0.8-cm thrombus from the right coronary cusp without an atherosclerotic lesion or calcification. Anticoagulant therapy with warfarin was subsequently initiated. No recurrent thrombosis has been observed for a year. Thus, early removal of a thrombus in the ascending aorta is considered a useful treatment strategy.
