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Figure 1
ECG trace: sinus rhythm, mild ST elevation, and inverted T waves in DI, aVL, V2-V6 and Q wave in DI, aVL, V4-V6.
Figure 2
2D transthoracic echocardiography – parasternal long axis view. A mobile, irregular mass (arrow), 21/11 mm, attached to the aortic root wall at the level of the left sinus of Valsalva with no impact on the aortic valve.
Figure 3
2D transesophageal echocardiography – mid-esophageal short axis view. The presence of a mobile mass (arrow), irregular, apparently with a pediculated insertion point near the commissure between the aortic noncoronary and left coronary cusps is confirmed.
Figure 4A
Thoracic computed tomography – axial plane. The mural irregular mass (arrow) is located in the aortic root at the left sinus of Valsalva level, in the proximity of the left main ostium.
*Courtesy of Dr. Dragoş Caravasile
Figure 4B
Thoracic computed tomography – axial plane. The proximity of the aortic mass (arrow) with the left main ostium is revealed.
*Courtesy of Dr. Dragoş Caravasile
Figure 5
Intraoperative image – median sternotomy. The aortotomy allows visualization of the aortic mass (asterisk): multilobed, friable, attached on the aortic wall through a pediculated insertion point near the commissure between noncoronary cusp and left coronary cusp.
Figure 6
Histopathological examination of the mass. Hematoxylin eosin coloration reveals organized thrombus mainly composed of fibrin and platelet cells. *Courtesy of Dr. Liliana Parascan
Figure 7A
Postoperative 2D-transthoracic echocardiography. Parasternal long axis view confirms the absence of the previously described mass, with normal function of the aortic valve.
Figure 7B
Postoperative 2D-transthoracic echocardiography. Parasternal short axis view confirms successful aortic thrombus resection with preserved integrity of the aortic valve and wall.