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Year : 2020  |  Volume : 30  |  Issue : 1  |  Page : 41-43

Left 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

1 Department of Cardiology, Ospedale San Giuseppe Multimedica, Milan, Italy
2 Department of Cardiovascular, Multimedica IRCCS, Milano, Italy

Correspondence Address:
Andrea Sonaglioni
Ospedale San Giuseppe Multimedica IRCCS, Via San Vittore 12, 20123 Milano
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_46_19

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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.

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