Publication Date
1-1-2022
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-20-7521
PMID
35201356
Publication Date(s)
January 2022
Language
English
PMCID
PMC8884279
PubMedCentral® Posted Date
2-24-2022
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Bariatric surgery, body mass index, heart transplantation/physiology/standards, heart-assist devices, nutritional status, obesity, morbid/complications/surgery, patient selection, retrospective studies, treatment outcome, weight loss/physiology
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Combining left ventricular assist device (LVAD) implantation and longitudinal sleeve gastrectomy may enable patients with morbid obesity to lose enough weight for heart transplant eligibility. In a retrospective study, we evaluated long-term outcomes of patients with body mass indexes ≥35 who underwent LVAD implantation and longitudinal sleeve gastrectomy during the same hospitalization (from January 2013 through July 2018) and then adhered to a dietary protocol. We included 22 patients (mean age, 49.9 ± 12.5 yr; mean preoperative body mass index, 43.3 ± 6.2). Eighteen months after gastrectomy, all 22 patients were alive, and 16 (73%) achieved a body mass index of less than 35. Myocardial recovery in 2 patients enabled LVAD removal. As of October 2020, 10 patients (45.5%) had undergone heart transplantation, 5 (22.3%) were waitlisted, 5 (22.3%) still had a body mass index ≥35, and 2 (9%) had died.
With LVAD support, longitudinal sleeve gastrectomy, and dietary protocols, most of our patients with morbid obesity and advanced heart failure lost enough weight for transplant eligibility. Support from physicians and dietitians can maximize positive results in these patients.