Congenital Absence of Left Atrial Appendage in a Patient with Intracranial Hemorrhage
Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease, Adverse events of drug therapy , Congenital defects / diseases, Educational Purpose (only if useful for a systematic review or synthesis)
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
Available online:
Published: 2015-08-04

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.
Keywords: Anticoagulants - therapeutic use, Atrial Appendage - abnormalities, Atrial Fibrillation - drug therapy, Intracranial Hemorrhages - diagnosis, Stroke - prevention & control