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

Patient: Male, 78 Final Diagnosis: Congenital absence of left atrial appendage Symptoms: None Medication: — Clinical Procedure: Transesophageal echocardiography • Cardiac CT Specialty: Cardiology OBJECTIVE: Rare disease 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.