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Journal Article
Observational Study
Laparoscopic sleeve gastrectomy in patients with heart failure and left ventricular assist devices as a bridge to transplant.
Surgery for Obesity and Related Diseases 2018 September
BACKGROUND: Obesity is an epidemic that is closely associated with heart failure. The ultimate treatment for end-stage heart failure is cardiac transplantation. Patients with morbid obesity are often excluded from receiving donor organs. Many transplant centers use body mass index (BMI) >35 kg/m2 as a contraindication to listing for heart transplant. Left ventricular assist devices (LVADs) were developed as a bridge to transplant for many heart failure patients, but bariatric surgery for LVAD patients has not been well described.
OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in LVAD patients and the impact on heart failure recovery as a bridge to cardiac transplantation.
SETTING: University hospital.
METHODS: A retrospective study was conducted to evaluate the outcomes of patients with morbid obesity and LVADs who underwent LSG at a large academic medical center between 2013 and 2017. Age, BMI, percent excess weight loss, cardiac ejection fraction, listing status for transplantation, and success of transplant were reviewed.
RESULTS: Eleven patients were identified with morbid obesity and heart failure with LVAD support who underwent LSG. There were no perioperative deaths. Four patients (37%) achieved BMI <35 and were successfully listed for and received cardiac transplantation. An additional 3 patients (27%) achieved BMI <35 kg/m2 and are listed for cardiac transplantation.
CONCLUSIONS: LSG can be safely used in patients with morbid obesity and end-stage heart failure requiring LVAD support to lower their BMI and become eligible for cardiac transplantation.
OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in LVAD patients and the impact on heart failure recovery as a bridge to cardiac transplantation.
SETTING: University hospital.
METHODS: A retrospective study was conducted to evaluate the outcomes of patients with morbid obesity and LVADs who underwent LSG at a large academic medical center between 2013 and 2017. Age, BMI, percent excess weight loss, cardiac ejection fraction, listing status for transplantation, and success of transplant were reviewed.
RESULTS: Eleven patients were identified with morbid obesity and heart failure with LVAD support who underwent LSG. There were no perioperative deaths. Four patients (37%) achieved BMI <35 and were successfully listed for and received cardiac transplantation. An additional 3 patients (27%) achieved BMI <35 kg/m2 and are listed for cardiac transplantation.
CONCLUSIONS: LSG can be safely used in patients with morbid obesity and end-stage heart failure requiring LVAD support to lower their BMI and become eligible for cardiac transplantation.
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