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We reviewed our experience of morbidly obese patients with end-stage heart failure that underwent left ventricular assist device (LVAD) implantation. From January 1, 2008 to January 1, 2018, 240 adult LVADs were implanted at our center. We reviewed the cases of patients presenting with end-stage heart failure and morbid obesity (preoperative body mass index [BMI] ≥ 35 kg/m2) who underwent LVAD-alone, and compared that to a group that underwent LVAD and bariatric surgery (laparoscopic sleeve gastrectomy [LSG]) as a means for weight reduction. Demographic characteristics, perioperative details, BMI, and status of transplant candidacy were recorded. Statistical analysis was performed (SPSS version 25) with χ2 analysis, Kaplan-Meier survival analysis, regression analysis, and Student's t-test. Twenty-nine patients met criteria and underwent LVAD implantation. Fifteen patients underwent LVAD-alone. Fourteen patients underwent LVAD + LSG. Both groups showed good survival outcomes, LVAD-alone (88.9 ± 5.9 months) versus LVAD +LSG (96.1 ± 12.4 months) but were not significantly different. However, we did note that more patients in the LVAD + LSG group were bridged to heart transplantation (p < 0.001). LVAD-alone and/or LVAD + LSG are both technically feasible and effective treatment options for the long-term survival of morbidly obese patients with end-stage heart failure. Combining LVAD + LSG can help bridge patients to heart transplantation.

The purpose of this study was to evaluate changes in physiologic parameters seen in a group of patients with chronic low back syndrome assigned to supervised and independent strength and conditioning programs. Forty patients with chronic low back syndrome were assigned either to a control group (independent exercise) or to an experimental group (supervised exercise). All subjects underwent pre-testing for aerobic fitness, strength and responses to visual analog pain rating scales. Twenty control subjects were given predesigned exercise programs and told to exercise four times per week for 6 months. Twenty experimental subjects were given predesigned exercise programs but were monitored by a strength and conditioning specialist for the same period. Statistically significant results were seen for increases in aerobic fitness and strength, decreases in reported pain, and percent body fat in the experimental group. Since the experimental group completed 90.75 sessions out of 96, compared with 31.95 for the control group, it could be concluded that supervision increases chances for compliance and success as measured by these parameters.