Back to Search
Start Over
Effect of Laparoscopic Sleeve Gastrectomy on Heart Transplant Status in 4 Patients with Left Ventricular Assist Devices
- Source :
- Tex Heart Inst J
- Publication Year :
- 2020
- Publisher :
- Texas Heart Institute Journal, 2020.
-
Abstract
- Bariatric surgery helps many morbidly obese patients lose substantial weight. However, few data exist on its long-term safety and effectiveness in patients who also have continuous-flow left ventricular assist devices and in whom heart transplantation is contemplated. We retrospectively identified patients at our institution who had undergone ventricular assist device implantation and subsequent laparoscopic sleeve gastrectomy from June 2015 through September 2017, and we evaluated their baseline demographic data, preoperative characteristics, and postoperative outcomes. Four patients (3 men), ranging in age from 32 to 44 years and in body mass index from 40 to 57, underwent sleeve gastrectomy from 858 to 1,849 days after left ventricular assist device implantation to treat nonischemic cardiomyopathy. All had multiple comorbidities. At a median follow-up duration of 42 months (range, 24–47 mo), median body mass index decreased to 31.9 (range, 28.3–44.3) at maximal weight loss, with a median percentage of excess body mass index lost of 72.5% (range, 38.7%–87.4%). After achieving target weight, one patient was listed for heart transplantation, another awaited listing, one was kept on destination therapy because of positive drug screens, and one regained weight and remained ineligible. On long-term follow-up, laparoscopic sleeve gastrectomy appears to be safe and feasible for morbidly obese patients with ventricular assist devices who must lose weight for transplantation consideration. Additional studies are warranted to evaluate this weight-loss strategy after transplantation and immunosuppression.
- Subjects :
- Adult
Male
Sleeve gastrectomy
medicine.medical_specialty
medicine.medical_treatment
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Gastrectomy
Weight loss
medicine
Humans
Case Series
Retrospective Studies
Heart Failure
Heart transplantation
business.industry
Middle Aged
Obesity, Morbid
Surgery
Transplantation
Treatment Outcome
Ventricular assist device
Heart Transplantation
Female
Laparoscopy
Median body
Heart-Assist Devices
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Body mass index
Follow-Up Studies
Destination therapy
Subjects
Details
- ISSN :
- 15266702 and 07302347
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Texas Heart Institute Journal
- Accession number :
- edsair.doi.dedup.....f9d728a3b0125792e64b9bd576cc7ce4