Bariatric Surgery In Obese Patients With Ventricular Assist Devices: A Single Center Experience

Abstract

Background Sleeve gastrectomy (SG) may be a useful intervention to help obese patients with ventricular assist devices (VADs) to improve their candidacy for heart transplantation (HT). However, much remains unknown about perioperative adverse events, weight changes and long-term outcomes. Methods Medical histories of all patients who underwent any bariatric surgery during VAD support in our large VAD/HT center were reviewed. Continuous variables were expressed in means (± standard deviations) or medians (p25-p75) and categorical variables were represented in percentages. The differences between body mass indices (BMIs) at different timepoints were analyzed with paired t-test and Spearman's correlations. P-values ≤ 0.05 were considered statistically significant. Results Between July 2016 and January 2020, eight patients with VADs underwent SG (age 43.8 [± 13.9] years old, 50% males). Mean time between VAD implantation and SG was 29.4 (± 16) months. There was a significant increase in BMI from VAD implantation (37.8 [± 6.7] kg/m2) to the time of SG (42.7 [± 4.5] kg/m2), p = 0.02). Other baseline, perioperative, and postoperative data can be found in Table 1. As early as 3-month after SG, BMIs had significantly decreased to 36.8 (± 4.2) kg/m2, (p Conclusions In this cohort, SG was an effective and safe means to help VAD patients to lose significant amount of weight in a short period of time, reversing the previous trend of weight gain after VAD implantation. Most of the patients did not require ICU admission or blood transfusion. Sleeve gastrectomy should be considered in morbidly obese VAD patients to improve their candidacy for HT.