Left atrial appendage closure and advanced chronic kidney disease: Another string to the bow

Abstract

Key points Patients with severe chronic kidney disease (CKD) and nonvalvular atrial fibrillation are underrepresented in left atrial appendage occlusion (LAAO) studies, despite their higher fragility and greater intolerance to antithrombotic therapy. LAAO appears to be safe and effective in reducing thromboembolic and bleeding recurrences both in patients with and without advanced CKD. Despite favorable ischemic and bleeding outcomes, patients with severe CKD experienced higher mortality rate, compared to those without severe CKD