Open AccessLeft atrial cavity thrombus and fatal systemic embolization in a stroke patient with nonvalvular atrial fibrillation: A caveat against left atrial appendage closure for stroke prevention
Author(s) -
Andrea Sonaglioni,
Antonio Vincenti,
Michele Lombardo,
Claudio Anzà
Publication year - 2020
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/jcecho.jcecho_46_19
Subject(s) - medicine , atrial fibrillation , cardiology , thrombus , embolization , stroke (engine) , heart failure , atrial appendage , thromboembolic stroke , percutaneous , appendage , aphasia , left ventricular thrombus , surgery , engineering , anatomy , psychiatry , mechanical engineering , sinus rhythm
An 88-year-old male with nonvalvular atrial fibrillation (NVAF) and severe congestive heart failure (HF), was admitted to the Neurological Intensive Care Unit because of the acute onset of aphasia and left hemiplegia. Transthoracic echocardiography revealed a left atrial (LA) cavity thrombus. Its "fatal" distal embolization to abdominal aorta occurred in a few days. These observations should lead to a cautious approach in proposing a percutaneous closure of LA appendage in older NVAF patients, with HF and/or left ventricular dysfunction and larger LA volumes, who are not adequately anticoagulated.