Bariatric surgery and left ventricular assist device in patients with heart failure: A systematic review and meta-analysis - 09/09/23
Abstract |
Background |
The role of metabolic and bariatric surgery (MBS), in synergy with left ventricular assist device (LVAD) implantation, in the scope of end-stage heart failure management for patients with severe obesity is not well elucidated.
Methods |
We conducted a meta-analysis using Cochrane, Embase, PubMed, and Scopus databases to include articles from their inception to November 2022.
Results |
A total of 271 patients who underwent MBS during or after the LVAD implantation were included from eleven separate studies. After surgery, 67.4% of patients were listed on the heart transplant waitlist with 32.5% undergoing a successful transplant. We reported a mean listing time of 13.8 months. Finally, the pooled postoperative complication rate, 30-day readmission rate, and one-year mortality rate were 47.6%, 23.6% and 10.2% respectively.
Conclusions |
MBS and LVAD is a safe and effective approach to bridge patients with severe obesity and end-stage heart failure for definitive heart transplantation.
Il testo completo di questo articolo è disponibile in PDF.Graphical abstract |
Highlights |
• | MBS is safe in patients with obesity and heart failure with an implanted LVAD. |
• | MBS leads to considerable and sustained weight loss in patients with LVAD. |
• | MBS successfully shortens time spent on the heart transplant waiting list. |
• | The majority of patients attain eligibility for heart transplant after MBS. |
• | MBS for patients with LVADs is an effective bridging therapy before transplantation. |
Keywords : Bariatric surgery, Sleeve gastrectomy, Heart failure, LVAD, Meta-analysis
Mappa
Vol 226 - N° 3
P. 340-349 - settembre 2023 Ritorno al numero
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