title: A Floating Thrombus Anchored at the Proximal Anastomosis of a Woven Thoracic Graft Mimicking a Genuine Aortic Dissection.
abstract: An aortoesophageal fistula following surgery for a ruptured 6.6-cm thoracic aneurysm in a 69-year-old female was repaired using a 34-mm woven prosthetic graft. A follow-up computed tomography (CT) scan at 10 days postoperatively revealed a dissection-like picture in the region of the graft, which was treated conservatively. The patient eventually died from sepsis and multiorgan failure. At autopsy, the graft was retrieved in situ and studied by detailed gross, microscopy, and scanning electron microscopy (SEM) examination. Gross observation confirmed that the dissection resulted from the rolling of the internal capsule downstream. A massive thrombus anchored at the proximal anastomosis and held by a narrow head was also noted. The thrombus demonstrated reorganization in the area of the anastomosis, with a false lumen in its distal half. The reminder of the thrombus consisted of layered fibrin. After gross examination, the fabric graft was found to be flawless. Additional detailed studies were also done using microscopy, SEM, and gross examination.
authors.affiliation: Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China; Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.affiliation: Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, China.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Olexandr
authors.initials: O
authors.lastname: Bondarenko
authors.affiliation: Department of Cardiovascular Surgery, Sacre-Coeur Hospital, Montreal and Department of Surgery, Universite de Montreal, Montreal, Quebec City, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Verdant
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rochette-Drouin
authors.affiliation: Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, PR. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Bourget
authors.affiliation: Vascular Surgery, St. Boniface General Hospital and Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Randolph
authors.initials: R
authors.lastname: Guzman
authors.affiliation: Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Ze
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Douville
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Germain
authors.affiliation: Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, P.R. China.
authors.forename: Zaiping
authors.initials: Z
authors.lastname: Jing
authors.affiliation: Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Guidoin
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008855:Microscopy, Electron, Scanning; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed