case_images: PMC2825769_01
case_images: Abdominal computed tomography scan showing multiple ischemic areas (arrows) in the right kidney (a) and in the spleen (b), suggesting an embolic source.
case_images: CRP2009-769694.001.jpg
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case_images: fig1
case_images: Abdominal computed tomography scan revealed multiple ischemic areas in the spleen and in the right kidney (Figures 1(a) and 1(b)), suggesting an embolic source.
case_images: (a) Transesophageal echocardiogram (TEE) image of the proximal descending aorta (PDA) with sectioning plane at 0 . A large polypoid sessile vegetation (2.1 x 0.9 cm) attached to the intima can be seen at the beginning of descending thoracic aorta (arrow); (b) TEE image of the PDA with sectioning plane at 117 , showing the same vegetation (arrow).
case_images: CRP2009-769694.002.jpg
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case_images: fig2
case_images: Transesophageal echocardiogram (TEE) revealed a large (2.1 x 0.9 cm) polypoid sessile vegetation with highly emboligenic characteristics at the beginning of descending thoracic aorta, suggesting infectious thoracic aortitis (Figures 2(a) and 2(b)).
case_images: Thoracic MRI performed before surgery, showing normal dimensions of the thoracic aorta (a) and a repletion defect (arrow) in the aortic arch-descending thoracic aorta transition compatible with a vegetation (b).
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case_images: PMC2825769_01_CRP2009-769694.003.jpg
case_images: fig3
case_images: TEE performed 4 weeks later showed no significant change in vegetation size (1.8 x 0.9 cm) and it was decided to perform surgical treatment (40th day of hospitalization). Thoracic magnetic resonance imaging (MRI) was performed before surgery, showing normal dimensions of the thoracic aorta and a repletion defect in the aortic arch-descending thoracic aorta transition compatible with a vegetation (Figures 3(a) and 3(b)).
case_images: Intraoperative image of the affected thoracic aortic segment with the vegetation (arrow).
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case_images: PMC2825769_01_CRP2009-769694.004.jpg
case_images: fig4
case_images: The affected aortic segment (Figure 4) was ressected with interposition of an aortic conduit (24 mm).
case_images: TEE image of the PDA, with sectioning plane at 0 , performed 4 weeks after surgery and before the discharge, showing the aortic conduit (arrow); (left) with a normal colour doppler flow (right).
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case_images: fig5
case_images: TEE performed before hospital discharge showed no changes besides the presence of the aortic conduit (Figure 5).