Laparoscopic Sleeve Gastrectomy in Patients with Obesity and Ventricular Assist Devices: a Comprehensive Outcome Analysis

daSilva‐deAbreu, Adrian; Garikapati, Kiran; Alhafez, Bader Aldeen; Desai, Sapna; Eiswirth, Clement; Krim, Selim R.; Patel, Hamang; Ventura, Héctor O.; Lavie, Carl J.; Loro-Ferrer, Juan Francisco; Mandras, Stacy A.

doi:10.1007/s11695-020-04948-9

Cited by 13 publications

(4 citation statements)

References 11 publications

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“…daSilva-deAbreu et al [14] studied 8 patients at a single heart transplant center and described LSG as an effective intervention to help obese LVAD-implanted individuals who wished to become candidates for heart transplantation. Furthermore, they point out that the low sample size for each center treating obese patients with LVADs demonstrates the need for creating a prospective multicenter registry to unify criteria for therapy [15].…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

et al. 2021

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Bariatric and metabolic surgery is currently the most effective procedure of achieving and maintaining weight loss. In the case under discussion, a 48-year-old male patient with heart insufficiency and an implanted left-ventricular assist device (LVAD) wanted to reduce his high BMI (48.6 kg/m2), so as to qualify for the heart transplant waiting list. According to the guidelines, he underwent all the required preoperative testing, which included psychosomatic clarifications, determination of endocrinological causes, and a nutritional consultation. During laparoscopic sleeve gastrectomy, a cardiac technician was present to support the anesthetist. After inserting 3 trocars with no complications, the greater curvature was mobilized using Medtronic’s bipolar electrothermal vessel-sealing instrument, LigaSure™. The resection was performed with an Ethicon™ endostapler. Postoperative monitoring showed no signs of hemorrhage. The patient’s BMI on the day of surgery was 46.8 kg/m2 and consecutively fell to 26.7 kg/m2 1 year after the procedure. Follow-up appointments revealed that the patient was fit and in good health. Thus, the patient’s aim of being listed on the transplant list was fulfilled, and at the time of this writing, he is ready to be matched with an organ donor. Because high-BMI patients with inserted LVADs are less likely to receive a donor graft and must remain longer on transplant waiting lists than normal-weight patients, bariatric and metabolic weight loss surgery may lead to a speedier resolution for these high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

et al. 2021

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“…Among those patients with heart failure, bariatric surgeries have been associated with improvements in quality of life, reverse cardiac remodeling [70] and even myocardial remission [71,72], slower progression of heart failure [73], and lower rates of hospitalization due to heart failure [80]. With bariatric surgery, certain patients with left ventricular assist devices have lost enough weight to become candidates for heart transplant, and some even achieved recovery of myocardial function [74 ▪▪ ,75,76].…”

Section: Integrating the Management Of Patient With Obesity Heart Fai...mentioning

confidence: 99%

Clinical considerations and pathophysiological associations among obesity, weight loss, heart failure, and hypertension

Barillas-Lara

Faaborg-Andersen

Quintana

et al. 2023

Current Opinion in Cardiology

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Purpose of review To describe the relationship between three pandemics: hypertension, obesity, and heart failure. From pathophysiology to treatment, understanding how these disease entities are linked can lead to breakthroughs in their prevention and treatment. The relevance of this review lies in its discussion of novel pharmacological and surgical treatment strategies for obesity and hypertension, and their role in the prevention and treatment of heart failure. Recent findings Novel medications such as GLP-1 agonists have demonstrated sustained weight loss in patients with obesity, and concurrent improvements in their cardiometabolic profile, and possibly also reductions in hypertension-related comorbidities including heart failure. Surgical therapies including laparoscopic bariatric surgery represent an important treatment strategy in obese patients, and recent studies describe their use even in patients with advanced heart failure, including those with ventricular assist devices. Summary These developments have deep implications on our efforts to understand, mitigate, and ultimately prevent the three pandemics, and offer promising improvements to quality of life, survival, and the cost burden of these diseases.

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“…Additionally, BS has proven to decrease the risk of developing HF by 46% when compared with an intensive lifestyle modification program during a median follow-up of 4.1 years [60]. In patients with HFrEF, BS has also led to significant improvement in LVEF, even in some patients with LV assist devices [61,62], and New York Heart Association functional class IV [63], as well as a significant decrease in the rates of HF hospitalizations/emergency department visits [64]. In HFpEF, BS has shown improvement in symptom burden and in parameters of diastolic function, including increase in E/A ratio, reduction of A wave, and shortening of the isovolumetric relaxation time, in addition to a decrease in LV end-diastolic and mass [65,66].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Interactions of hypertension, obesity, left ventricular hypertrophy, and heart failure

daSilva‐deAbreu

Alhafez

Lavie

et al. 2021

Current Opinion in Cardiology

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Purpose of reviewHypertension (HTN) and obesity are major risk factors for cardiac remodeling and dysfunction, leading to left ventricular hypertrophy (LVH) and heart failure (HF). In this review, we discuss the complex mechanisms and effects of HTN and obesity, and their treatments in LVH, ventricular function, and HF. Recent findingsObesity and HTN impact the heart through overlapping neurohormonal pathways. However, the relationship between obesity and cardiomyopathy is more complex, and additional metabolic and hemodynamic pathways seem to contribute to cardiac dysfunction in these patients. Weight loss and blood pressure (BP) control help to prevent and reverse at least some of the damage caused by obesity and HTN even beyond what would be expected from solely the hemodynamic changes. SummaryObesity and HTN cause maladaptive changes in the heart that can lead to LVH and HF. Weight loss and BP control help to, at least partially, reverse some of these changes and improve clinical outcomes in patients with HF.

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Laparoscopic Sleeve Gastrectomy in Patients with Obesity and Ventricular Assist Devices: a Comprehensive Outcome Analysis

Cited by 13 publications

References 11 publications

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

Clinical considerations and pathophysiological associations among obesity, weight loss, heart failure, and hypertension

Interactions of hypertension, obesity, left ventricular hypertrophy, and heart failure

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