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Effect of obesity on outcomes in patients undergoing implantation of continuous-flow left ventricular assist devices

Nastasya Volkovicher1,2, Chitaru Kurihara3,4,5, Andre Critsinelis1,2

  • 1Division of Cardiothoracic Transplant and Assist Devices, Baylor College of Medicine, Houston, TX, USA.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
|January 27, 2018
PubMed

Insights

Obesity does not negatively impact outcomes for patients receiving a continuous-flow left ventricular assist device (CF-LVAD). Obese patients experience similar survival rates and complication risks compared to normal-weight and overweight individuals, suggesting obesity is not a contraindication for CF-LVAD implantation.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Surgical Outcomes

Background:

  • Obesity is a growing concern in heart failure management.
  • Continuous-flow left ventricular assist devices (CF-LVADs) are crucial for end-stage heart failure.
  • The impact of obesity on CF-LVAD outcomes requires further investigation.

Purpose of the Study:

  • To analyze the effect of obesity on patient outcomes following CF-LVAD implantation.
  • To determine if obesity is a significant predictor of mortality or complications in CF-LVAD recipients.

Main Methods:

  • Retrospective analysis of 526 patients implanted with CF-LVADs (HeartMate II or HeartWare HVAD).
  • Patients stratified into normal-weight, overweight, and obese groups based on BMI (excluding underweight).
  • Postoperative complications and survival rates were reviewed and compared across BMI groups.

Main Results:

  • Survival rates at 1, 6, 12, and 24 months were similar across normal-weight, overweight, and obese patient groups.
  • Obesity was not found to be a significant predictor of mortality in Cox proportional hazard models.
  • No significant difference in postoperative complications was observed between BMI groups.

Conclusions:

  • Appropriately selected obese patients achieve similar survival benefits from CF-LVADs as non-obese patients.
  • Obesity should not be considered a contraindication for CF-LVAD implantation.
  • Further research may explore specific management strategies for obese CF-LVAD recipients.

Keywords:
Body mass index (BMI)Heart failureLeft ventricular assist device (LVAD)Obesity

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