Laparoscopic sleeve gastrectomy in patients with heart failure and left ventricular assist devices as a bridge to transplant

Hawkins, Russell B.; Go, Kristina L.; Raymond, Steven L.; Ayzengart, Alexander; Friedman, Jeffrey

doi:10.1016/j.soard.2018.04.005

Cited by 40 publications

(25 citation statements)

References 26 publications

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“…Their BMIs were below 35, and both successfully underwent LVAD explantation. The improvement in LVEF for these two patients (25-30%) was significantly higher than patients reported in previously published studies [10][11][12][13][14][15][16][17][18] and obviated the need for cardiac transplantation.…”

Section: Discussioncontrasting

confidence: 49%

Regression of severe heart failure after combined left ventricular assist device placement and sleeve gastrectomy

et al. 2021

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Patients who suffer morbid obesity and heart failure (HF) present unique challenges. Two cases are described where concomitant use of laparoscopic sleeve gastrectomy (LSG) and left ventricular assist device (LVAD) placement enabled myocardial recovery and weight loss resulting in explantation. A 29-year-old male patient with a body mass index (BMI) of 59 kg/m 2 and severe HF with a left ventricular ejection fraction (LVEF) of 20-25% underwent concomitant LSG and LVAD placement. Sixteen months after surgery, his BMI was reduced to 34 kg/m 2 and his LVEF improved to 50-55%. A second 41-year-old male patient with a BMI of 44.8 kg/m 2 with severe HF underwent the same procedures. Twenty-four months later, his BMI was 31.1 kg/m 2 and his LVEF was 50-55%. In both cases, the LVAD was successfully explanted and patients remain asymptomatic. HF teams should consult and collaborate with bariatric experts to determine if LSG may improve the outcomes of their HF patients.

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Section: Discussioncontrasting

confidence: 49%

Regression of severe heart failure after combined left ventricular assist device placement and sleeve gastrectomy

et al. 2021

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“…Pre–lung transplant weight loss significantly improves survival and decreases days on the ventilator, so any intervention resulting in weight loss can have significant impacts on outcomes and survival. Patients with morbid obesity who are able to undergo LSG can facilitate weight loss and improve eligibility for transplant . In patients with end‐stage lung disease, select patients with obesity undergoing bariatric surgery can have improvement of their lung disease and function, as well as pulmonary hypertension, through the weight loss …”

Section: Cardiothoracic Transplantmentioning

confidence: 99%

Obesity, transplantation, and bariatric surgery: An evolving solution for a growing epidemic

Diwan

Lee

Nagai

et al. 2020

American Journal of Transplantation

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Obesity is a worldwide epidemic. In 2005, 25% of the world population was overweight (as defined by body mass index [BMI] 25-29.9 kg/m 2) and 10% was obese (BMI > 30 kg/m 2). 1 By 2030, the prevalence is projected to reach 38% overweight and 20% obese. In the United States, the rates of obesity in 2014 were 35% of men and 40% of women. 2 The health-related ramifications of obesity have been well documented, including but not limited to cardiovascular disease, diabetes mellitus (DM), and cancer. 3-5 In patients with end-organ disease, obesity-related comorbidities can influence access to transplant, technical aspects of the transplant operations, and posttransplant outcome. Although class 1 obesity (BMI 30-34.9 kg/m 2) is not typically a contraindication, class 2 (BMI 35-39.9 kg/m 2) and class 3 (BMI > 40 kg/ m 2) obesity can be relative or absolute contraindications to transplant. Findings from a survey of

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“…Preoperative testing included an upper gastrointestinal series that revealed normal esophageal motility, no hiatal hernia, and no gastroesophageal reflux. LSG was chosen over Rouxen-Y gastric bypass for technical ease, shorter operative time, perioperative safety profile, and effective weight loss in end-stage HF patients [5][6][7] .…”

Section: Preoperative Carementioning

confidence: 99%

Use of an intra-aortic balloon pump during laparoscopic sleeve gastrectomy

Narvaez¹,

Pérez²,

Castro³

et al. 2020

MIS

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Heart transplant is the primary treatment for end-stage heart failure; however, morbid obesity limits candidacy. Bariatric surgery performed in patients with advanced heart failure improves eligibility for heart transplantation. This is the first report of an intra-aortic balloon pump used during laparoscopic sleeve gastrectomy. A patient with morbid obesity and non-ischemic cardiomyopathy was referred for weight loss surgery prior to evaluation for heart transplantation. An intra-aortic balloon pump was placed for aggressive diuresis and cardiovascular support during laparoscopic sleeve gastrectomy. The patient did not suffer any complications or require readmission. The use of an intra-aortic balloon pump as a mechanical circulatory system provided a safe laparoscopic sleeve gastrectomy in a patient with advanced heart failure.

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Laparoscopic sleeve gastrectomy in patients with heart failure and left ventricular assist devices as a bridge to transplant

Cited by 40 publications

References 26 publications

Regression of severe heart failure after combined left ventricular assist device placement and sleeve gastrectomy

Regression of severe heart failure after combined left ventricular assist device placement and sleeve gastrectomy

Obesity, transplantation, and bariatric surgery: An evolving solution for a growing epidemic

Use of an intra-aortic balloon pump during laparoscopic sleeve gastrectomy

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