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Journal of Biomedical Research | Volume: 29
November 19-20, 2018 | Paris, France
Molecular Biology, Tissue Science and Regenerative Medicine
International Conference on
Joint Event
&
4
th
World Heart Congress
Laparoscopic sleeve gastrectomy in a patient with severe ischemic heart failure requiring a left
ventricular assist device as a bridge to cardiac transplantation
Jeffrey E Friedman
University of Florida, USA
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. This causes left ventricular dilatation, cardiac
hypertrophy 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/m
2
. We
describe our method of laparoscopic sleeve gastrectomy in
patients with heart failure requiring a left ventricular assist
device as a means for weight loss in order to bridge the patient
to cardiac transplantation.
Methods:
A 63 year old male with morbid obesity (BMI 40 kg/
m
2
) and multiple co-morbidities including chronic congestive
heart failure with an ejection fraction of 20% requiring left
ventricular device support was referred to the bariatric service
for laparoscopic sleeve gastrectomy as a method of weight loss
in order to become eligible for cardiac transplantation listing.
After completing the bariatric work-up, the patient was pre-
admitted to the heart failure service and prepared for surgery.
Laparoscopic sleeve gastrectomy was performed in a standard
fashion over a 36 French bougie.
Results:
Post-operatively the patient recovered in the heart
failure unit, was immediately started on the bariatric protocol,
a heparin drip restarted 6 hours post-operatively and was
discharged home when his INR was therapeutic without
complication
Conclusion:
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 a
director of bariatric surgery. Friedman 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. Friedman 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.friedman@surgery.ulf.eduJeffrey E Friedman, Molecular Biology & Heart Congress 2018, Volume 29
DOI: 10.4066/biomedicalresearch-C8-022