title: Transesophageal ecocardiography: the correct intraoperative way to detect the source of peripheral embolism in an emergency.
abstract: Arterial thromboembolism in patients with an unknown source of embolization is associated with significant morbidity and mortality. Once the acute process has been treated, a search of the offending embolic source must be conducted to prevent additional episodes. The most common sources of peripheral embolism include intracardiac thrombi (>85%), thrombus within arterial aneurysm, thrombus overlying complex atherosclerotic plaques, and paradoxical embolization from deep venous thrombus. A strong association has been shown between protruding, noncalcified plaques>4 cm in the aorta detected by transesophageal echocardiography and the risk of embolism. Moreover, as many as 25-50% of protruding plaques may have superimposed mobile thrombi ranging from one to several centimeters, and this imparts a high embolic risk. The formation of thrombi in morphologically normal aorta is a rare event. We report a case of peripheral embolization in a young man caused by a thrombus in the descending aorta detected by transesophageal echocardiography.
authors: Cardiovascular Department, Santa Croce Hospital, Cuneo, Italy. Electronic address: ilablange@yahoo.it.
authors: Ilaria
authors: I
authors: Blangetti
authors: Lorena
authors: L
authors: Fenoglio
authors: Carla
authors: C
authors: Avallato
authors: Marco
authors: M
authors: Bertora
authors: Claudio
authors: C
authors: Novali
authors: Flavio
authors: F
authors: Peinetti
authors: Alessandro
authors: A
authors: Locatelli
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004636:Emergency Service, Hospital; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D011237:Predictive Value of Tests; D017131:Thrombectomy; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome