Impact of Laparoscopic Sleeve Gastrectomy on Medical Therapy of LVAD Patients

Abstract

Introduction Morbid obesity of class II or higher (BMI ≥ 35) is common in the heart failure population and is associated with poor outcomes after advanced heart failure therapies. Only 15% of obese left ventricular assist device (LVAD) patients are able to achieve adequate weight loss which permits heart transplantation. It has been reported that laparoscopic sleeve gastrectomy (LSG) is promising in this population given efficacy and minimally invasive nature. We sought to describe how a decrease in BMI post LSG impacts medical therapy with the hypothesis it may improve response to heart failure medical therapy. Methods We retrospectively reviewed LVAD patients who underwent LSG 2013 and 2019 at the University of Florida. Inclusion criteria included age > 18 and continued LVAD support for ≥ 6 months post LSG. Clinical data at 6 months follow-up was analyzed. Results We found 14 patients meeting the inclusion criteria. Mean age was 41 years and 61% were men. No major acute complications were noted post operatively from LSG. Mean BMI decreased from 44 to 34 (P Conclusions In this single center experience, in addition to providing succesful reduction in BMI conducive to heart transplantation, LSG was feasible and associated with significant reduction in antihypertensive and anticoagulation requirements.