Abstract 16793: Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients With End-Stage Heart Failure and LVAD
Introduction: The prevalence of obesity and heart failure is increasing in the United States. Heart transplant is contraindicated in morbidly obese patients due to poor outcomes. Bariatric surgery may increasingly be considered for LVAD patients to achieve transplant eligibility.
Hypothesis: Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure as a means to increase and improve transplant candidacy of morbidly obese LVAD patients with end-stage heart failure.
Methods: This was a single center, case-series of six morbidly obese patients with end-stage heart failure post LVAD implantation, who underwent LSG between 2013 and 2015. Demographic characteristics, perioperative details, weight loss, and status of transplant candidacy were analyzed.
Results: Six patients (2 men) with morbid obesity and end-stage heart failure post LVAD underwent LSG. Median age was 42 (27-57) years and mean preoperative body mass index (BMI) was 44.02±3.94 kg/m2. Median operative time was 90 (88-105) minutes, with a median length of stay of 6 (3-9) days. There were no perioperative deaths. Post-operatively, there was no significant complication including no infection and no anticoagulation issue. At median follow-up of 6 (5-14) months, the mean weight loss was 34.2±14.7kg with a decrease in BMI to 32.99±4.9 kg/m2 (P<.05). Five out of six patients had lost sufficient weight to become transplant eligible. Two patients were successfully transplanted and three are currently active on the transplant list.
Conclusions: In this small case-series, LSG appears to be a safe, technically feasible, and effective method for obtaining adequate weight loss in morbidly obese patients with end-stage heart failure and mechanical circulatory support. LSG may serve as a bridge to heart transplantation in otherwise ineligible patients.
Author Disclosures: R. Zolty: None. J. Um: None. E. Raichlin: None. H. Vongooru: None. A.F. Burdorf: None. T.R. Ryan: None. S.M. Yannone: None. A. Siddique: None. M. Moulton: None. B.D. Lowes: None.
- © 2016 by American Heart Association, Inc.