Multiorgan emboli due to an intraluminal thrombus from frozen elephant trunk

Cardiovasc Pathol. 2021 May-Jun:52:107316. doi: 10.1016/j.carpath.2020.107316. Epub 2021 Jan 14.

Abstract

The impact of kinking of the nonstented part of a frozen elephant trunk on the development of adverse effects is unclear. We report a case of an infected thrombus within the kinked nonstented portion of the frozen elephant trunk that resulted in multiorgan embolization. A 45-year-old man presented with a 1-month history of high-grade fever and fatigue. He had undergone emergent total arch replacement and frozen elephant trunk implantation for type A acute aortic dissection 7 years previously. Computed tomography showed an intraluminal thrombus within the kinked nonstented portion of the frozen elephant trunk. An autopsy also showed an intraluminal thrombus within the graft and diffuse microembolization in the abdominal organs. Therefore, in this case, kinking of the nonstented part of the frozen elephant trunk had resulted in an infected intraluminal thrombus, which subsequently caused multiorgan embolization.

Keywords: Frozen elephant trunk; Intraluminal thrombus; Septic emboli; Total arch replacement.

Publication types

  • Case Reports

MeSH terms

  • Aortic Dissection / surgery
  • Autopsy
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Embolism* / diagnosis
  • Embolism* / etiology
  • Humans
  • Male
  • Middle Aged
  • Thrombosis* / complications
  • Thrombosis* / diagnosis
  • Thrombosis* / etiology