RECURRENT MOBILE THROMBUS OF THE ASCENDIN G AORTA DIAGNOSED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY

The authors report the case of a 32 year old woman with no risk factor s for thromboembolism apart from araised Lipoprotein (a) level, in who m a mobile thrombus of the ascending aorta was diagnosed only by trans cesophageal echocardiography after multiple episodes of systemic embol ism. After surgical excision the thrombus recurred and death ensued on the 17th postoperative day after multiple visceral embolism despite a dequate anticoagulant therapy. This is a rare condition, the outcome o f which seems often to be fatal, due to early recurrence irrespective of the treatment (anticoagulant or platelet antiaggregant therapy). Th is case illustrates the value of systematic transoesophageal echocardi ography for the investigation of cerebral or peripheral ischaemic epis odes without carotid artery disease and raises the problem of the best way of treating this pathology.