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Journal of Biomedical Research | Volume: 29
4th World Heart Congress
Molecular Biology, Tissue Science and Regenerative Medicine
International Conference on
Joint Event
&
November 19-20, 2018 | Paris, France
Background: Obesity is associated with heart failure due to
structural and functional changes within the heart. Obesity
increases metabolic demand, total blood volume and stroke
volume.Thiscausesleftventriculardilatation,cardiachypertrophy
and atrial enlargement. Definitive treatment for severe heart
failure is cardiac transplantation. Transplantation is not an
option for patients with a BMI over 35 kg/m2. Bariatric surgery is
themost effectivemeans of sustainedweight losswhendiet and
exercise fail, however there are very few reports of weight loss
surgery in patients with advanced heart failure in the literature.
Methods: Thirteen morbidly obese patients with end stage
heart failure with left ventricular assist device (LVAD) in place
that underwent LSG between 2013 and 2018, were reviewed
retrospectively. All thirteen patients suffered from severe
advanced heart failure requiring left ventricular assist device
support. Bariatric, cardiac and renal parameters, operative and
postoperative complications, comorbidities and United Nation
of Organ Sharing (UNOS) transplant candidacy status were
analyzed.
Results: 6 of the 13 patients achieved adequate weight loss
with a BMI under 35 and received a heart transplantation. 5
of the 13 patients achieved adequate weight loss with a BMI
under 35 and are listed for transplantation with status 1B. 2
of the 13 patients achieved adequate weight loss and had
significant improvement in ejection fraction and are currently
under evaluation for removal of their LVAD.
Conclusion: Advanced heart failure requiring LVAD support
in association with obesity is a difficult problem, sleeve
gastrectomy can be safely utilized in patients with end-stage
heart failure and morbid obesity in order to achieve weight
loss to become eligible for transplant listing.
Speaker Biography
Jeffrey E Friedman is as an assistant professor in the division of general surgery and
the director of bariatric surgery. He earned his medical degree from the University
of Mississippi and completed his residency in general surgery at Carraway Methodist
Medical Center in Birmingham, Alabama and Mary Imogene Bassett Healthcare in
Cooperstown, New York. He served as a research fellow at the Mary Imogene Bassett
Research Institute and as a minimally invasive surgery/bariatric surgery fellow at
Sacred Heart Health System in Pensacola, Florida. He has previously worked as
assistant medical director of the Sacred Heart Institute for Medical Weight Loss, as
medical director of the Baptist Healthcare Bariatric Program in Pensacola and as chief
of the minimally invasive surgery/bariatric program at Previty Clinic for Surgical Care in
Beaumont, Texas. He has twice received the American Medical Association’s Physician’s
Recognition Award and is a member of the American College of Surgeons, the Society
of American Gastrointestinal and Endoscopic Surgeons, the Pensacola Surgical Society
and the American Society of Metabolic and Bariatric Surgeons.
e:
Jeffrey E Friedman
University of Florida, USA
Obesity and advanced heart failure, can bariatric surgery help?
Jeffrey E Friedman, Molecular Biology & Heart Congress 2018, Volume 29
DOI: 10.4066/biomedicalresearch-C8-021