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Revista Colombiana de Nefrología
versão On-line ISSN 2500-5006
Resumo
ROSSELLI SANMARTIN, Carlos et al. Management with the Watchman device in a patient with atrial fibrillation and on dialysis therapy. Case report and narrative review. Rev. colom. nefrol. [online]. 2020, vol.7, n.2, pp.104-112. Epub 25-Abr-2021. ISSN 2500-5006.
Anticoagulation remains the therapy of choice for the majority of patients with non-valvular atrial fibrillation, however, in patients with chronic kidney disease at high risk of bleeding, local antithrombotic therapies such as the left atrial closure with Watchman device should be considered. We report the first case of implant of this type device in the Hospital de San José at the City of Bogotá, Colombia, and a narrative review of the literature is made. Watchman's use is associated with fewer hemorrhagic strokes (0.15 versus 0.96 events / 100 patients-year HR: 0.22; p = 0.004), cardiovascular death / unexplained death (1.1 vs. 2.3 events / 100 patient-year; HR: 0.48; p = 0.006), and bleeding not associated with the procedure (6.0 % vs. 11.3 %; HR: 0.51; p = 0.006) compared to warfarin.
Palavras-chave : atrial fibrillation; dialysis; peritoneal dialysis; chronic kidney disease; atrial appendage (MeSH).