Laparoscopic sleeve gastrectomy in a patient with severe ischemic heart failure requiring a left ventricular assist device as a bridge to cardiac transplantation
Joint Event on International Conference on Molecular Biology, Tissue Science and Regenerative Medicine & 4th World Heart Congress
November 19-20, 2018 | Paris, France
Jeffrey E Friedman
University of Florida, USA
Scientific Tracks Abstracts : Biomed Res
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/m2. 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/ m2) 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 preadmitted 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.
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.
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