Jorge M. Largo-Gil, Departamento de Medicina Interna, Clínica las Américas, Medellín, Colombia
Julián M. Aristizábal, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital San Vicente; Departamento de Electrofisiología, Clínica Las Américas; Medellín, Colombia
Juan C. Díaz, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital San Vicente; Departamento de Electrofisiología, Clínica Las Américas; Medellín, Colombia
Jorge E. Marín, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital San Vicente; Departamento de Electrofisiología, Clínica Las Américas; Medellín, Colombia
César D. Niño, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital Pablo Tobón Uribe; Medellín, Colombia
Oriana Bastidas, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital San Vicente; Departamento de Electrofisiología, Clínica Las Américas; Medellín, Colombia
Juanita Velásquez, Departamento de Cardiología, Clínica CES, Medellín, Colombia
Mauricio Duque, Posgrado de Electrofisiología, Universidad CES; Departamento de Electrofisiología, Hospital San Vicente, Medellín, Colombia
Introduction: left atrial appendage closure (LAAO) is a therapeutic alternative in patients with nonvalvular atrial fibrillation (NVAF) when anticoagulation is contraindicated. In patients with renal replacement therapy and NVAF, the embolic risk is accompanied by a very high risk of bleeding. Anticoagulant therapy has not demonstrated an adequate risk-benefit relationship. Objetive: to describe the population of patients with atrial fibrillation on renal replacement therapy who undergo percutaneous appendage closure and the immediate results of the intervention. Method: retrospective, multicenter, descriptive study was carried out on the cases of patients with NVAF and chronic kidney disease on renal replacement therapy who were taken to the LAAO from 2017 to 2022. Results: Series of 25 patients with: average age 68.8 years, 68% were men, 100% had hypertension, 52% type 2 diabetes mellitus, 36% coronary disease. The embolic risk measured by CHA2DS2-VASc on average was 4 points. The systolic function measured by LVEF was on average 55%. 48% were receiving anticoagulant therapy. Regarding the device, 76% were WATCHMAN and 24% Amulet. The procedure was successful in 96%. There were 4 non-serious complications. There were no intervention-related ischemic cerebrovascular events or deaths. Conclusion: LAAO in patients with renal replacement therapy has shown to be an effective and safe alternative, with a low rate of complications and a favorable initial follow-up.
Keywords: Atrial fibrillation. Renal replacement therapy. Atrial appendage. Anticoagulants. Vascular closure devices.
