o:3049 Surgical treatment of ascending aorta floating thrombus in a patient with recent SARS-CoV-2 infection en ABSTRACT: The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Doppler ultrasonography revealed occlusion of the right brachial and right common carotid artery. Subsequently, computed tomography (CT) scan confirmed the occlusion of the right brachial and common carotid artery, and revealed pedunculated floating ascending aortic mass. The floating thrombus in ascending aorta is a rare and potentially very dangerous pathological condition. Although aetiology is still unclear, ascending aorta atherosclerosis and coagulation disorder are probably the most common reasons. Hypercoagulable state, high level of antiphospholipid antibody and factor VIII are closely relating with vascular thrombosis. Since the outbreak of the coronavirus-2019 (COVID-19) pandemic, increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might produce hypercoagulable state with subsequent thrombosis and thromboembolism. The infection elevated the level of factor VIII in the blood and, consequently, increased the risk of adverse thrombotic and embolic events. Additionally, endothelial inflammation and injury mediated by coronavirus represent an additional risk factor. According to literature, this is the first case of the floating ascending aorta thrombus in the patient with SARS-CoV-2 infection. The thrombus’ fragile structure and high blood velocity through the ascending aorta significantly increases cerebral and peripheral embolization incidence, with potentially fatal outcome. Due to frequent adverse events, urgent surgical extirpation is the best therapy option. We presented successfully surgically treated giant floating thrombus in the ascending aorta and aortic arch in a patient with recent SARS-CoV-2 infection with acute right arm ischemia due to embolic complication. Key words: ascending aorta, thrombus, aortic arch, embolization, SARS-CoV-2 91552100 125463049 1552101 2223-3660 1552099 10.21037/cdt-20-1010 2023-10-18T16:22:38.940Z 44 yes 46 Igor Živković 104607753 0000-0001-9601-4201 2021 46 Petar Milačić 61900297 0000-0002-5528-7921 2021 46 Vladimir Mihajlović 104929289 2021 46 Staša Krasić 28395623 0000-0002-3007-5631 2021 46 Jelena Lešanović 33780071 0009-0001-3658-6643 2021 46 Miodrag Perić 12463719 0000-0002-6431-1903 2021 46 Đorđe Zdravković 104934921 0000-0001-9864-4856 2021 application/pdf 831256 https://unilib.phaidrabg.rs/o:3049 no yes 1 70 616.132-089:616.9 92000006 71A11 Cardiovascular Diagnosis and Therapy. 11 2 467 471 2021