Background

Obesity is a known contributor to heart failure, and many patients with end-stage heart failure are being managed with left ventricular assist device (LVAD) implantation. Previous studies of bariatric surgery outcomes of patients with history of LVAD implantation are largely from single- institutions, with small sample sizes.

Methods

We used the 2022 version of MBSAQIP to understand nationally representative outcomes after bariatric surgery for patients with history of LVAD. We analyzed the baseline characteristics and preoperative comorbidities, and tabulated the occurences of postoperative complications within 30 days.

Results

In total, 120 patients in the 2022 version of MBSAQIP had a recorded history of LVAD implantation. Patients generally had multiple comorbidities, including diabetes (38%), hypertension (84%), anticoagulation (63%), and ASA class of III and IV (37%, 60%). The most commonly performed procedure was laparoscopic sleeve gastrectomy (79%), followed by laparoscopic roux-en-y gastric bypass (13%). 10 (8.3%) of patients required a transfusion in the 72 hours after the procedure, and 3 (2.5%) experienced gastrointestinal tract bleeding. In this group, 2 (1.7%) had a reintervention, 7 (5.8%) had a reoperation, 12 (10%) had a readmission, and 1 (0.8%) experienced death within 30 days. All but 1 patient (99%) were able to be discharged home after their procedure.

Conclusions

Excellent outcomes after bariatric surgery can be achieved for patients with previous history of left ventricular assist device placement. Further study is needed to understand the comparative risks and benefits of different bariatric procedures for this high-risk population.