Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke: a case report

Andreas Bugge Tinggaard; Kasper Korsholm; Jesper Møller Jensen; Jens Erik Nielsen-Kudsk

doi:10.1093/ehjcr/ytaa027

Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke: a case report

Andreas Bugge Tinggaard^*, Kasper Korsholm, Jesper Møller Jensen, Jens Erik Nielsen-Kudsk

^*Corresponding author for this work

Department of Clinical Medicine - The Department of Cardiological Medicine B

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

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.

Original language	English
Journal	European Heart Journal: Case Reports
Volume	4
Issue	2
Pages (from-to)	1-4
Number of pages	4
DOIs	https://doi.org/10.1093/ehjcr/ytaa027
Publication status	Published - Apr 2020

Keywords

Anticoagulation
Atrial fibrillation
Case report
Left atrial appendage occlusion
Stroke

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title = "Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke: a case report",

abstract = "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.",

keywords = "Anticoagulation, Atrial fibrillation, Case report, Left atrial appendage occlusion, Stroke",

author = "Tinggaard, {Andreas Bugge} and Kasper Korsholm and Jensen, {Jesper M{\o}ller} and Nielsen-Kudsk, {Jens Erik}",

note = "{\textcopyright} The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.",

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Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke: a case report. / Tinggaard, Andreas Bugge ; Korsholm, Kasper; Jensen, Jesper Møller et al.
In: European Heart Journal: Case Reports, Vol. 4, No. 2, 04.2020, p. 1-4.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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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

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KW - Stroke

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Spontaneously occluded left atrial appendage in a patient with atrial fibrillation and stroke: a case report

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