BMI Trends In Patients With Ventricular Assist Devices After Bariatric Surgery

Abstract

Background : There is paucity of knowledge about the efficacy of bariatric surgery (BS) to achieve sustained weight loss in ventricular assist device (VAD) patients. Furthermore, the wide range of body mass index (BMI) and length of follow-up have made it impossible for small cohort studies to predict BMI trends after BS in VAD patients, in whom evidence from the general bariatric population may not be accurate. Results: For the 29 patients included, the mean age was 41.9 (± 12.2) years. All patients underwent either laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass. The baseline BMI at the time of BS was 45.2 (± 6.7) kg/m2. Every patient had lower BMI during follow-up than at the time of BS (Figure 1). Seven patients experienced some degree of weight gain ≥ 12 months after BS. There were statistically significant correlations (all P < 0.0001) between time (months) and trends in BMI (rho -0.662), cumulative BMI change (rho 0.885), and percentage of excess BMI (rho 0.860). Furthermore, 57.1% (16 of 28) of the patients achieved transplantation or myocardial recovery after weight loss. Conclusions : Obese patients with VADs experience significant decreases in BMI, especially in excess BMI, over time after undergoing BS, although some patients re-gained some weight after one year. These results are promising, but further research, ideally with large registries combining bariatric, VAD, and transplantation outcomes, could provide more valuable insight to help identify predictive factors and guide patient selection for BS with VADs.