title: Congenital Absence of Left Atrial Appendage in a Patient with Intracranial Hemorrhage.
abstract: BACKGROUND
  Intracranial hemorrhage is the most serious complication of anticoagulant therapy and is itself an absolute contraindication to further treatment.
  
  
  METHODS
  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.
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Gioia
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Mega
authors.affiliation: Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Visconti
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Cosimo Marco
authors.initials: CM
authors.lastname: Campanale
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Creta
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ragni
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000002:abnormalities*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000175:diagnosis*; D008297:Male; D020521:Stroke / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants