Bariatric surgery in patients with left ventricular assist devices: a safe and effective method of weight loss as a gateway to heart transplantation

Ariela Zenilman, David Pechman, Erin Moran-Atkin, Jenny Choi, Diego Camacho

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Severe cardiac disease often warrants intervention to improve cardiac function, such as mechanical support via a left ventricular assist device (LVAD). While this is an effective way of improving myocardial activity, it works synergistically with weight loss. Setting: Academic hospital. Objective: The aim of this study was to evaluate bariatric surgery as an alternative means of weight loss to improve cardiac status. Methods: Six patients with LVADs underwent sleeve gastrectomies (SG) over a 5-year study period (2014–2018). Patient characteristics, cardiac history, operative outcomes, and follow-up was evaluated by univariate analyses. Results: Median age at operation was 49.8 years (range, 24–58 yr) with average weight at surgery of 126.6 kg. Average body mass index at time of SG was 41.4 kg/m2. Median hospital length of stay was 8.5 days (range, 4–13 d), with postoperative length of stay of 5.5 days (3–7 d). Total follow-up was 29 months (range, 7–51 mo). Postoperative readmission occurred in 2 patients (33%) without significant adverse outcomes. Four patients (67%) were listed for transplant, 3 within 1 year of LSG. Three patients (50%) underwent orthotopic heart transplant. All patients experienced improved cardiac co-morbidities after SG. Conclusion: We demonstrate that weight loss surgery as a bridge to transplantation for patients with implanted LVADs can be performed in young and middle-aged adults. Although it is limited by sample size, the reported results add to the existing literature highlighting the potential success of bariatric surgery in high-risk patient populations to achieve weight loss goals, impact cardiac co-morbidities, and improve overall quality of life.

Original languageEnglish (US)
Pages (from-to)1780-1784
Number of pages5
JournalSurgery for Obesity and Related Diseases
Volume15
Issue number10
DOIs
StatePublished - Oct 2019

Keywords

  • Bariatric surgery
  • Heart transplantation
  • Left ventricular assist device
  • Perioperative complications
  • Sleeve gastrectomy
  • Weight loss surgery

ASJC Scopus subject areas

  • Surgery

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