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Congenital Absence of Left Atrial Appendage in a Patient with Intracranial Hemorrhage

Giuseppe Di Gioia, Simona Mega, Silvia Visconti, Cosimo Marco Campanale, Antonio Creta, Laura Ragni, Germano Di Sciascio

(Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy)

Am J Case Rep 2015; 16:514-516

DOI: 10.12659/AJCR.894331


BACKGROUND: Intracranial hemorrhage is the most serious complication of anticoagulant therapy and is itself an absolute contraindication to further treatment.
CASE REPORT: We present the case of a 78-year-old patient with permanent atrial fibrillation and previous intracranial hemorrhage during oral anticoagulation therapy, who was a candidate for percutaneous closure of the left atrial appendage. Transesophageal echocardiography and computed tomography showed absence of the left atrial appendage. The patient continued with single antiplatelet therapy.
CONCLUSIONS: Absence of the left atrial appendage is a very rare congenital condition usually found in patients scheduled for cardiovascular procedures and without clinical significance. The risk of thromboembolism is reasonably low but unknown.

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