Situs inversus totalis is a rare defect which can present difficulties in the management in laparoscopic surgery due to the mirror-image anatomy. Herein, we report a patient with situs inversus totalis and super-super-obesity (BMI 76 kg/m2). We performed successful laparoscopic sleeve gastrectomy. Technical details of this operation, with situs inversus totalis, are presented. There were no major difficulties compared to patients with usual anatomy. There are potential diseases associated with situs inversus and obesity; therefore, a careful investigation, including a chest x-ray and cardiac and abdominal ultrasounds should be performed before surgery. Sleeve gastrectomy is an adequate procedure in super-super-obese patients with situs inversus totalis.

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21Objectives. Implantable left ventricular assist device (LVAD) is a major therapeutic progress 22 for end-stage heart failure in selected patients. As their use is expanding, infectious 23 complications are emerging, with limited data available to guide their management. We 24 aimed to better characterize LVAD-related infections. 25Methods. We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 26 referral centers in France, using standardized definition of infections in patients with LVAD. 27Data were collected from medical charts using a standardized questionnaire. with the use of prolonged antibacterial treatment in 34 (94%), and debridement in 17 (47%). 40One patient died due to LVAD-associated infection. 41Conclusions. LVAD-related infections are common after LVAD implantation, and may be 42 controlled by prolonged antibiotic treatment.

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