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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Percutaneous Left Atrial Appendage Closure in Patients with Non-Valvular Atrial Fibrillation and End-Stage Renal
Elena Basabe1, José C De La Flor2, Virginia López de la Manzanara3
1Department of Cardiology, Hospital Central Defense Gómez Ulla, 28047 Madrid, Spain.
Medicina (Kaunas, Lithuania)
|February 24, 2024
Summary
Percutaneous left atrial appendage closure (LAAC) offers a safe and effective stroke prevention alternative for patients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) on hemodialysis, particularly those with bleeding risks.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Non-valvular atrial fibrillation (NVAF) is common, especially in chronic kidney disease (CKD) patients on hemodialysis.
- This high-risk population faces significant bleeding and thrombotic events, with limited oral anticoagulation treatment (OAT) options.
- Percutaneous left atrial appendage closure (LAAC) presents a potential alternative for stroke prevention.
Observation:
- A retrospective study evaluated eight NVAF patients with CKD on hemodialysis undergoing percutaneous LAAC.
- Patients had high CHA 2 DS 2 -VAS C and HAS-BLED scores, with most referred due to major bleeding history.
- The mean age was 78.8 years, with 70% being male.
Findings:
- Percutaneous LAAC was 100% successful, achieving complete appendage exclusion without significant complications.
- One non-procedure-related death occurred post-intervention.
- The remaining seven patients experienced no deaths, cardioembolic events, or major bleeding during 12-month follow-up.
Implications:
- Percutaneous LAAC demonstrates safety and efficacy as an alternative to OAT in NVAF patients with CKD on hemodialysis.
- This procedure may reduce stroke risk in a challenging patient cohort.
- Further research is warranted to confirm these findings in larger studies.
Keywords:
atrial fibrillationend-stage renal diseasehemodialysispercutaneous left atrial appendage closureMore Related Videos
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