Ventricular Assist Device Implantation and Bariatric Surgery: A Route to Transplantation in Morbidly Obese Patients with End-Stage Heart Failure
Autor: | Mustafa Ahmed, Thomas M. Beaver, Jeffrey Friedman, Charles T. Klodell, Amber Miller, George J. Arnaoutakis, Eric I. Jeng, Stephen A Tapia-Ruano, Juan Vilaro, Juan M. Aranda, Alex M. Parker, Kevin Reilly |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Biomedical Engineering Biophysics Bariatric Surgery Bioengineering 030204 cardiovascular system & hematology Body Mass Index Biomaterials 03 medical and health sciences 0302 clinical medicine Weight loss Weight Loss medicine Humans Survival analysis Retrospective Studies Heart Failure Heart transplantation business.industry General Medicine Perioperative Middle Aged equipment and supplies medicine.disease Combined Modality Therapy Obesity Morbid Surgery Transplantation Treatment Outcome 030228 respiratory system Heart failure Ventricular assist device Heart Transplantation Female Heart-Assist Devices medicine.symptom business Body mass index |
Zdroj: | ASAIO Journal. 67:163-168 |
ISSN: | 1058-2916 |
Popis: | 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. |
Databáze: | OpenAIRE |
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