Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis
Purpose A body mass index (BMI) > 35 kg/m 2 is a relative contraindication to heart transplantation in patients with end-stage heart failure. Bariatric surgery can be considered either concomitantly with continuous-flow left ventricular assist device (CF-LVAD) placement, or staged after CF-LVAD h...
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| Veröffentlicht in: | Obesity surgery 2020-11, Vol.30 (11), p.4437-4445 |
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| creator | Challapalli, Jothika Maynes, Elizabeth J. O’Malley, Thomas J. Cross, Devon E. Weber, Matthew P. Choi, Jae Hwan Aggarwal, Rajesh Boyle, Andrew J. Whellan, David J. Entwistle, John W. Massey, H. Todd Morris, Rohinton J. Tchantchaleishvili, Vakhtang |
| description | Purpose
A body mass index (BMI) > 35 kg/m
2
is a relative contraindication to heart transplantation in patients with end-stage heart failure. Bariatric surgery can be considered either concomitantly with continuous-flow left ventricular assist device (CF-LVAD) placement, or staged after CF-LVAD has been placed. We sought to evaluate the outcomes of these approaches.
Materials and Methods
An electronic search was performed to identify all relevant studies. After assessment for inclusion and exclusion criteria, eight studies were pooled for systematic review and metaanalysis.
Results
Overall, of 59 patients, 22 (37%) underwent simultaneous sleeve gastrectomy with CF-LVAD implantation while 37 (63%) underwent staged sleeve gastrectomy after CF-LVAD. The mean age of patients was 46 years (95% CI: 39–53) with 40% females. Mean BMI at most recent follow-up (33.4 kg/m
2
, 95% CI: 30.2–36.6) was significantly lower compared with mean preoperative BMI (46.7 kg/m
2
, 95% CI: 42.9–50.6) (
p
|
| doi_str_mv | 10.1007/s11695-020-04834-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_32654017</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2645318395</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-36e634acda3edefc3fd1df3cadba04ca110b04861651d7348af80242092196583</originalsourceid><addsrcrecordid>eNqNkU9v1DAQxS0EokvhC3BAlrggocD4bxJuq0AL0iIQBa6R15mAq2zS2k5Xy6dnSkqROCBOtse_9zQzj7HHAl4IgPJlEsLWpgAJBehK6ULfYStRQkVPWd1lK6gtFFUt1RF7kNI5gBRWyvvsSElrNIhyxX6cDYhXyE9dyhF9nnYHHkb-0eWAY058H_J33kxjDuM8zak4GaY932Cf-Vf6j8HPg4t8nVJImb_Gq-AxveKOnx1Sxh25eP6Jqrjnbuz4e8yuWI9uOBD_kN3r3ZDw0c15zL6cvPncvC02H07fNetN4VVpcqEsWqWd75zCDnuv-k50vfKu2zrQ3gkBWxrfCmtEVypdub4CqSXUUtTWVOqYPVt8L-J0OWPK7S4kj8PgRqSRWmKVuV4bEPr0L_R8miP1S5TVRolK1YYouVA-TilF7NuLGHYuHloB7XUy7ZJMS8m0v5JpNYme3FjP2x12t5LfURBQLcAet1OfPO3f4y0GAEaXypQ13UA0IdNup7GZ5jGT9Pn_S4lWC52IGL9h_DPkP_r_CaSMukE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2645318395</pqid></control><display><type>article</type><title>Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Challapalli, Jothika ; Maynes, Elizabeth J. ; O’Malley, Thomas J. ; Cross, Devon E. ; Weber, Matthew P. ; Choi, Jae Hwan ; Aggarwal, Rajesh ; Boyle, Andrew J. ; Whellan, David J. ; Entwistle, John W. ; Massey, H. Todd ; Morris, Rohinton J. ; Tchantchaleishvili, Vakhtang</creator><creatorcontrib>Challapalli, Jothika ; Maynes, Elizabeth J. ; O’Malley, Thomas J. ; Cross, Devon E. ; Weber, Matthew P. ; Choi, Jae Hwan ; Aggarwal, Rajesh ; Boyle, Andrew J. ; Whellan, David J. ; Entwistle, John W. ; Massey, H. Todd ; Morris, Rohinton J. ; Tchantchaleishvili, Vakhtang</creatorcontrib><description>Purpose
A body mass index (BMI) > 35 kg/m
2
is a relative contraindication to heart transplantation in patients with end-stage heart failure. Bariatric surgery can be considered either concomitantly with continuous-flow left ventricular assist device (CF-LVAD) placement, or staged after CF-LVAD has been placed. We sought to evaluate the outcomes of these approaches.
Materials and Methods
An electronic search was performed to identify all relevant studies. After assessment for inclusion and exclusion criteria, eight studies were pooled for systematic review and metaanalysis.
Results
Overall, of 59 patients, 22 (37%) underwent simultaneous sleeve gastrectomy with CF-LVAD implantation while 37 (63%) underwent staged sleeve gastrectomy after CF-LVAD. The mean age of patients was 46 years (95% CI: 39–53) with 40% females. Mean BMI at most recent follow-up (33.4 kg/m
2
, 95% CI: 30.2–36.6) was significantly lower compared with mean preoperative BMI (46.7 kg/m
2
, 95% CI: 42.9–50.6) (
p
< 0.01). There was no significant difference in total incidence of postoperative complications (simultaneous, 16% (95% CI: 1–87%) versus staged, 23% (95% CI: 7–53%)) or in overall survival (simultaneous, 93% (95% CI: 72–99%) versus staged, 79% (95% CI: 60–90%),
p
= 0.17) for average follow-up time of 12.7 months. Bariatric surgery resulted in 66% of patients (95% CI: 51–79) to be listed for heart transplantation, including 33% (95% CI: 22–47) who were transplanted.
Conclusions
Both simultaneous and staged bariatric surgeries with CF-LVAD placement have comparable outcomes and significantly reduce BMI. This can allow previously ineligible patients to undergo heart transplantation.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04834-4</identifier><identifier>PMID: 32654017</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Body mass index ; Female ; Gastrectomy ; Gastrointestinal surgery ; Heart ; Heart Failure - surgery ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Life Sciences & Biomedicine ; Male ; Medicine ; Medicine & Public Health ; Meta-analysis ; Middle Aged ; Obesity, Morbid - surgery ; Original Contributions ; Retrospective Studies ; Science & Technology ; Surgery ; Systematic review ; Treatment Outcome</subject><ispartof>Obesity surgery, 2020-11, Vol.30 (11), p.4437-4445</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>13</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000547357900001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-36e634acda3edefc3fd1df3cadba04ca110b04861651d7348af80242092196583</citedby><cites>FETCH-LOGICAL-c375t-36e634acda3edefc3fd1df3cadba04ca110b04861651d7348af80242092196583</cites><orcidid>0000-0002-6870-8211 ; 0000-0002-5302-2065</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04834-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04834-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27931,27932,28255,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32654017$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Challapalli, Jothika</creatorcontrib><creatorcontrib>Maynes, Elizabeth J.</creatorcontrib><creatorcontrib>O’Malley, Thomas J.</creatorcontrib><creatorcontrib>Cross, Devon E.</creatorcontrib><creatorcontrib>Weber, Matthew P.</creatorcontrib><creatorcontrib>Choi, Jae Hwan</creatorcontrib><creatorcontrib>Aggarwal, Rajesh</creatorcontrib><creatorcontrib>Boyle, Andrew J.</creatorcontrib><creatorcontrib>Whellan, David J.</creatorcontrib><creatorcontrib>Entwistle, John W.</creatorcontrib><creatorcontrib>Massey, H. Todd</creatorcontrib><creatorcontrib>Morris, Rohinton J.</creatorcontrib><creatorcontrib>Tchantchaleishvili, Vakhtang</creatorcontrib><title>Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Purpose
A body mass index (BMI) > 35 kg/m
2
is a relative contraindication to heart transplantation in patients with end-stage heart failure. Bariatric surgery can be considered either concomitantly with continuous-flow left ventricular assist device (CF-LVAD) placement, or staged after CF-LVAD has been placed. We sought to evaluate the outcomes of these approaches.
Materials and Methods
An electronic search was performed to identify all relevant studies. After assessment for inclusion and exclusion criteria, eight studies were pooled for systematic review and metaanalysis.
Results
Overall, of 59 patients, 22 (37%) underwent simultaneous sleeve gastrectomy with CF-LVAD implantation while 37 (63%) underwent staged sleeve gastrectomy after CF-LVAD. The mean age of patients was 46 years (95% CI: 39–53) with 40% females. Mean BMI at most recent follow-up (33.4 kg/m
2
, 95% CI: 30.2–36.6) was significantly lower compared with mean preoperative BMI (46.7 kg/m
2
, 95% CI: 42.9–50.6) (
p
< 0.01). There was no significant difference in total incidence of postoperative complications (simultaneous, 16% (95% CI: 1–87%) versus staged, 23% (95% CI: 7–53%)) or in overall survival (simultaneous, 93% (95% CI: 72–99%) versus staged, 79% (95% CI: 60–90%),
p
= 0.17) for average follow-up time of 12.7 months. Bariatric surgery resulted in 66% of patients (95% CI: 51–79) to be listed for heart transplantation, including 33% (95% CI: 22–47) who were transplanted.
Conclusions
Both simultaneous and staged bariatric surgeries with CF-LVAD placement have comparable outcomes and significantly reduce BMI. This can allow previously ineligible patients to undergo heart transplantation.</description><subject>Body mass index</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastrointestinal surgery</subject><subject>Heart</subject><subject>Heart Failure - surgery</subject><subject>Heart Transplantation</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU9v1DAQxS0EokvhC3BAlrggocD4bxJuq0AL0iIQBa6R15mAq2zS2k5Xy6dnSkqROCBOtse_9zQzj7HHAl4IgPJlEsLWpgAJBehK6ULfYStRQkVPWd1lK6gtFFUt1RF7kNI5gBRWyvvsSElrNIhyxX6cDYhXyE9dyhF9nnYHHkb-0eWAY058H_J33kxjDuM8zak4GaY932Cf-Vf6j8HPg4t8nVJImb_Gq-AxveKOnx1Sxh25eP6Jqrjnbuz4e8yuWI9uOBD_kN3r3ZDw0c15zL6cvPncvC02H07fNetN4VVpcqEsWqWd75zCDnuv-k50vfKu2zrQ3gkBWxrfCmtEVypdub4CqSXUUtTWVOqYPVt8L-J0OWPK7S4kj8PgRqSRWmKVuV4bEPr0L_R8miP1S5TVRolK1YYouVA-TilF7NuLGHYuHloB7XUy7ZJMS8m0v5JpNYme3FjP2x12t5LfURBQLcAet1OfPO3f4y0GAEaXypQ13UA0IdNup7GZ5jGT9Pn_S4lWC52IGL9h_DPkP_r_CaSMukE</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Challapalli, Jothika</creator><creator>Maynes, Elizabeth J.</creator><creator>O’Malley, Thomas J.</creator><creator>Cross, Devon E.</creator><creator>Weber, Matthew P.</creator><creator>Choi, Jae Hwan</creator><creator>Aggarwal, Rajesh</creator><creator>Boyle, Andrew J.</creator><creator>Whellan, David J.</creator><creator>Entwistle, John W.</creator><creator>Massey, H. Todd</creator><creator>Morris, Rohinton J.</creator><creator>Tchantchaleishvili, Vakhtang</creator><general>Springer US</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6870-8211</orcidid><orcidid>https://orcid.org/0000-0002-5302-2065</orcidid></search><sort><creationdate>20201101</creationdate><title>Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis</title><author>Challapalli, Jothika ; Maynes, Elizabeth J. ; O’Malley, Thomas J. ; Cross, Devon E. ; Weber, Matthew P. ; Choi, Jae Hwan ; Aggarwal, Rajesh ; Boyle, Andrew J. ; Whellan, David J. ; Entwistle, John W. ; Massey, H. Todd ; Morris, Rohinton J. ; Tchantchaleishvili, Vakhtang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-36e634acda3edefc3fd1df3cadba04ca110b04861651d7348af80242092196583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Body mass index</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastrointestinal surgery</topic><topic>Heart</topic><topic>Heart Failure - surgery</topic><topic>Heart Transplantation</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Challapalli, Jothika</creatorcontrib><creatorcontrib>Maynes, Elizabeth J.</creatorcontrib><creatorcontrib>O’Malley, Thomas J.</creatorcontrib><creatorcontrib>Cross, Devon E.</creatorcontrib><creatorcontrib>Weber, Matthew P.</creatorcontrib><creatorcontrib>Choi, Jae Hwan</creatorcontrib><creatorcontrib>Aggarwal, Rajesh</creatorcontrib><creatorcontrib>Boyle, Andrew J.</creatorcontrib><creatorcontrib>Whellan, David J.</creatorcontrib><creatorcontrib>Entwistle, John W.</creatorcontrib><creatorcontrib>Massey, H. Todd</creatorcontrib><creatorcontrib>Morris, Rohinton J.</creatorcontrib><creatorcontrib>Tchantchaleishvili, Vakhtang</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Challapalli, Jothika</au><au>Maynes, Elizabeth J.</au><au>O’Malley, Thomas J.</au><au>Cross, Devon E.</au><au>Weber, Matthew P.</au><au>Choi, Jae Hwan</au><au>Aggarwal, Rajesh</au><au>Boyle, Andrew J.</au><au>Whellan, David J.</au><au>Entwistle, John W.</au><au>Massey, H. Todd</au><au>Morris, Rohinton J.</au><au>Tchantchaleishvili, Vakhtang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>30</volume><issue>11</issue><spage>4437</spage><epage>4445</epage><pages>4437-4445</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Purpose
A body mass index (BMI) > 35 kg/m
2
is a relative contraindication to heart transplantation in patients with end-stage heart failure. Bariatric surgery can be considered either concomitantly with continuous-flow left ventricular assist device (CF-LVAD) placement, or staged after CF-LVAD has been placed. We sought to evaluate the outcomes of these approaches.
Materials and Methods
An electronic search was performed to identify all relevant studies. After assessment for inclusion and exclusion criteria, eight studies were pooled for systematic review and metaanalysis.
Results
Overall, of 59 patients, 22 (37%) underwent simultaneous sleeve gastrectomy with CF-LVAD implantation while 37 (63%) underwent staged sleeve gastrectomy after CF-LVAD. The mean age of patients was 46 years (95% CI: 39–53) with 40% females. Mean BMI at most recent follow-up (33.4 kg/m
2
, 95% CI: 30.2–36.6) was significantly lower compared with mean preoperative BMI (46.7 kg/m
2
, 95% CI: 42.9–50.6) (
p
< 0.01). There was no significant difference in total incidence of postoperative complications (simultaneous, 16% (95% CI: 1–87%) versus staged, 23% (95% CI: 7–53%)) or in overall survival (simultaneous, 93% (95% CI: 72–99%) versus staged, 79% (95% CI: 60–90%),
p
= 0.17) for average follow-up time of 12.7 months. Bariatric surgery resulted in 66% of patients (95% CI: 51–79) to be listed for heart transplantation, including 33% (95% CI: 22–47) who were transplanted.
Conclusions
Both simultaneous and staged bariatric surgeries with CF-LVAD placement have comparable outcomes and significantly reduce BMI. This can allow previously ineligible patients to undergo heart transplantation.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32654017</pmid><doi>10.1007/s11695-020-04834-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6870-8211</orcidid><orcidid>https://orcid.org/0000-0002-5302-2065</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-8923 |
| ispartof | Obesity surgery, 2020-11, Vol.30 (11), p.4437-4445 |
| issn | 0960-8923 1708-0428 |
| language | eng |
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| subjects | Body mass index Female Gastrectomy Gastrointestinal surgery Heart Heart Failure - surgery Heart Transplantation Heart-Assist Devices Humans Life Sciences & Biomedicine Male Medicine Medicine & Public Health Meta-analysis Middle Aged Obesity, Morbid - surgery Original Contributions Retrospective Studies Science & Technology Surgery Systematic review Treatment Outcome |
| title | Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis |
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