[Monocentric experience of left atrial appendage occlusion among patients with advanced chronic kidney disease and non-valvular atrial fibrillation]

G Ital Nefrol. 2020 Feb 12;37(1):2020-vol1.
[Article in Italian]

Abstract

Atrial fibrillation is the most common cardiac disorder among chronic nephropathic patients. Possible therapeutic approaches include the use of anticoagulants, which are able to reduce the risk of thromboembolism but lead to an increasing bleeding risk, especially in this cohort of patients. Also, novel oral anticoagulant agents (NAO), due to their mainly renal clearance, are a relative contraindication in advanced renal disease. As an alternative to the oral anticoagulant therapy, left atrial appendage occlusion seems a promising opportunity in high risk, difficult to manage patients. Since there is limited evidence of LAAO in advanced chronic renal disease or dialysis patients, we report here a monocenter experience on 12 patients (6 of which in regular dialytic treatment) with a median clinical follow-up of fourteen months (3-22 months).

Keywords: LAAO; NAO; advanced chronic kidney disease; atrial fibrillation; dialysis; left atrial appendage occlusion.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects
  • Atrial Appendage* / diagnostic imaging
  • Atrial Fibrillation / complications*
  • Contraindications, Drug
  • Factor Xa Inhibitors / therapeutic use
  • Hemorrhage / chemically induced
  • Humans
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Renal Dialysis
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / therapy
  • Risk Assessment
  • Therapeutic Occlusion / instrumentation*
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Factor Xa Inhibitors