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Medical Science Monitor Basic Research


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

Italy 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