Operative management of ascending aorta thrombus and bilateral pulmonary embolism in the setting of breast cancer

Pulmonary embolism and concomitant floating aortic thrombus are a rare and potentially life-threatening association. Several therapeutic options are available and best management can be controversial when these conditions coexist. We describe a case of a 79-year-old woman presented with massive pulmonary embolism and simultaneous floating thrombus in the ascending aorta. She underwent concomitant ascending aortic replacement and surgical pulmonary embolectomy with an uneventful postoperative recovery. Open surgical repair is a one stage repair approach that may offer the most efficient treatment to allow survival.