Effect of laparoscopic sleeve gastrectomy on heart transplant status in 4 patients with left ventricular assist devices

Christopher T. Ryan, Adriana Santiago, Nabil Tariq, Harveen K. Lamba

Research output: Contribution to journalArticlepeer-review

Abstract

Bariatric surgery helps many morbidly obese patients lose substantial weight. However, few data exist on its long-term safety and effectiveness in patients who also have continuous-flow left ventricular assist devices and in whom heart transplantation is contemplated. We retrospectively identified patients at our institution who had undergone ventricular as-sist device implantation and subsequent laparoscopic sleeve gastrectomy from June 2015 through September 2017, and we evaluated their baseline demographic data, preoperative characteristics, and postoperative outcomes. Four patients (3 men), ranging in age from 32 to 44 years and in body mass index from 40 to 57, underwent sleeve gastrectomy from 858 to 1,849 days after left ventricular assist device implantation to treat nonischemic cardiomyopathy. All had multiple comorbidities. At a median follow-up duration of 42 months (range, 24-47 mo), median body mass index decreased to 31.9 (range, 28.3-44.3) at maximal weight loss, with a median per-centage of excess body mass index lost of 72.5% (range, 38.7%-87.4%). After achiev-ing target weight, one patient was listed for heart transplantation, another awaited listing, one was kept on destination therapy because of positive drug screens, and one regained weight and remained ineligible. On long-term follow-up, laparoscopic sleeve gastrectomy appears to be safe and fea-sible for morbidly obese patients with ventricular assist devices who must lose weight for transplantation consideration. Additional studies are warranted to evaluate this weight-loss strategy after transplantation and immunosuppression.

Original languageEnglish (US)
Pages (from-to)284-289
Number of pages6
JournalTexas Heart Institute Journal
Volume47
Issue number4
DOIs
StatePublished - Aug 1 2020

Keywords

  • Adaptation
  • Body mass index
  • Cardiovascular diseas-es/physiopathology
  • Gastrectomy/methods
  • Heart failure/ complications
  • Heart-assist devices/adverse effects
  • Morbid/ complications/surgery
  • Obesity
  • Obesity/complications/physiopathology
  • Physiological
  • Retrospective studies
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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