TY - JOUR
T1 - Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke
T2 - a case report
AU - Tinggaard, Andreas Bugge
AU - Korsholm, Kasper
AU - Jensen, Jesper Møller
AU - Nielsen-Kudsk, Jens Erik
N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2020/4
Y1 - 2020/4
N2 - Background : The left atrial appendage (LAA) is the main source of thromboembolism in atrial fibrillation (AF). Transcatheter closure is non-inferior to warfarin therapy in preventing stroke.Case summary : A patient with two consecutive strokes associated with AF was referred for transcatheter LAA occlusion (LAAO). Preprocedural cardiac CT and transoesophageal echocardiography demonstrated a spontaneously occluded LAA with a smooth left atrial surface, with stationary results at 6- and 12-month imaging follow-up. Warfarin was discontinued, and life-long aspirin instigated.Discussion : Left atrial appendage occlusion has shown non-inferiority to warfarin for prevention of stroke, cardiovascular death, and all-cause mortality. No benefits from anticoagulation have been demonstrated in patients with embolic stroke of undetermined source. In the present case, we observed that the LAA was occluded and, therefore, treated with aspirin monotherapy assuming similar efficacy as transcatheter LAAO.
AB - Background : The left atrial appendage (LAA) is the main source of thromboembolism in atrial fibrillation (AF). Transcatheter closure is non-inferior to warfarin therapy in preventing stroke.Case summary : A patient with two consecutive strokes associated with AF was referred for transcatheter LAA occlusion (LAAO). Preprocedural cardiac CT and transoesophageal echocardiography demonstrated a spontaneously occluded LAA with a smooth left atrial surface, with stationary results at 6- and 12-month imaging follow-up. Warfarin was discontinued, and life-long aspirin instigated.Discussion : Left atrial appendage occlusion has shown non-inferiority to warfarin for prevention of stroke, cardiovascular death, and all-cause mortality. No benefits from anticoagulation have been demonstrated in patients with embolic stroke of undetermined source. In the present case, we observed that the LAA was occluded and, therefore, treated with aspirin monotherapy assuming similar efficacy as transcatheter LAAO.
KW - Anticoagulation
KW - Atrial fibrillation
KW - Case report
KW - Left atrial appendage occlusion
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85101412913&partnerID=8YFLogxK
U2 - 10.1093/ehjcr/ytaa027
DO - 10.1093/ehjcr/ytaa027
M3 - Journal article
C2 - 32352058
SN - 2514-2119
VL - 4
SP - 1
EP - 4
JO - European Heart Journal: Case Reports
JF - European Heart Journal: Case Reports
IS - 2
ER -