Optimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. We report a rare case of a fluttering cord-like thrombus extending from the ascending aorta to the left carotid artery that was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. The patient had an uneventful postoperative course and was discharged 9 days after surgery.