Contemporary Nationwide Heart Transplantation and Left Ventricular Assist Device Outcomes in Patients with Histories of Bariatric Surgery |
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| Institution: | 1. Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA;2. Division of Cardiology, Department of Medicine, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA;3. Division of Cardiothoracic Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ;4. Department of Medicine, Forrest General Hospital, Hattiesburg, MS;5. Cardiovascular Research Institute, RWJ Barnabas Health, Newark, NJ;6. Division of Cardiology, Duke University Medical Center, Durham, NC;7. Duke Clinical Research Institute, Durham, NC;1. Zena and Michael A. Wiener Cardiovascular Institute and Department of Population Health Science and Policy, Mount Sinai, New York, NY, USA;2. Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA;1. From the Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan;2. Center for Individualized and Genomic Medicine Research, Henry Ford Hospital, Detroit, Michigan;3. Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan;4. Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan;5. Heart and Vascular Institute, Henry Ford Health System, Detroit, Michigan;1. Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada;2. Department of Medicine, University of Toronto, Toronto, Canada;3. Division of Cardiology, Department of Medicine, Mount Sinai Hospital/University Health Network, Toronto, Canada;1. Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois;2. Division of Cardiology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio;4. Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland;5. Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland;1. Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina;2. Duke Clinical Research Institute, Durham, North Carolina |
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| Abstract: | Bariatric surgery may play a role in the management of morbidly obese patients with end-stage heart failure through increasing eligibility and improving the outcomes of destination therapies. We conducted a nationally representative, retrospective cohort study of patients with previous bariatric surgery undergoing either heart transplantation or left ventricular assist device implantation. Of 200 patients, < 6% experienced in-hospital mortality after destination therapy, comparable to that reported in the general population of heart recipients. Risk-adjusted outcomes differed minimally from those of obese patients undergoing destination therapy without previous bariatric surgery. This study provides important safety benchmarking data and demonstrates the feasibility of bariatric surgery as a potential bridge to left ventricular assist device implantation or heart transplantation in obese patients with end-stage heart failure. |
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