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Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?

The Impact of Obesity on Left Ventricular Assist Device Outcomes

Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, University Duisburg-Essen, 45122 Essen, Germany
International Thoracic and Cardiovascular Research Association (ITCVR), 26133 Oldenburg, Germany
Department of Cardiovascular Surgery at the Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, University of Pernambuco, Recife 74970-240, Brazil
Department of Medicine, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
Department of Cardiothoracic Surgery, Heart Center Essen Huttrop, University Hospital Essen, 45138 Essen, Germany
Department of Thoracic and Cardiovascular Surgery, University Medical Centre Tubingen, 72076 Tubingen, Germany
Author to whom correspondence should be addressed.
Medicina 2020, 56(11), 556;
Received: 23 September 2020 / Revised: 20 October 2020 / Accepted: 21 October 2020 / Published: 23 October 2020
(This article belongs to the Special Issue Ventricular Assist Device Therapy in Heart Failure)
Background and Objectives: The understanding of high body mass index (BMI) and outcomes after Left Ventricular Assist Device (LVAD) implantation continues to evolve and the relationship has not been established yet. In this study, we investigated the effects of obesity (BMI > 30 kg/m2) on post–LVAD implantation outcomes. HeartWare LVAD and Heart Mate III LVAD were implanted. The primary outcome that was measured was mortality (in-hospital and on follow-up). The secondary outcomes that were measured were major adverse events. Materials and Methods: At our institution, the West German Heart and Vascular Center (Essen, Germany), from August 2010 to January 2020, a total of 210 patients received a long-term LVAD. Patients were stratified according to BMI ≥ 30 kg/m2 representing the obesity threshold. The first group (n = 162) had an average BMI of 24.2 kg/m2 (±2.9), and the second group (n = 48) had an average BMI of 33.9 kg/m2 (±3.2). Baseline demographics were analysed alongside comorbidities per group. Results: Overall mortality was not significantly different between the obese group (51.1% n = 24) and the nonobese group (55.2%, n = 85) (p = 0.619). The difference between the mean duration of survival of patients who expired after hospital discharge was insignificant (2.1 years ± 1.6, group 1; 2.6 years ± 1.5, group 2; p = 0.29). In-hospital mortality was unvaried between the two groups: group 1: n = 34 (44% out of overall group 1 deaths); group 2: n = 11 (45.8% out of overall group 2 deaths) (p > 0.05). Postoperative complications were unvaried between the obese and the non-obese group (all with p > 0.05). However, a significant difference was found with regards to follow-up neurological complications (18.5% vs. 37.8%, p = 0.01) and LVAD thrombosis (14.7% vs. 33.3%, p = 0.01), as both were higher in the obese population. Conclusion: Obesity does not form a barrier for LVAD implantation in terms of mortality (in-hospital and on follow up). However, a significantly higher incidence of follow-up LVAD thrombosis and neurological complications has been found in the obese group of patients. View Full-Text
Keywords: left ventricular assist device; obesity; mechanical circulatory support; heart failure; cardiac assist and artificial heart left ventricular assist device; obesity; mechanical circulatory support; heart failure; cardiac assist and artificial heart
MDPI and ACS Style

Zhigalov, K.; Sá, M.P.B.O.; Arjomandi Rad, A.; Vardanyan, R.; Goerdt, L.; Chrosch, T.; Zubarevich, A.; Wendt, D.; Pizanis, N.; Koch, A.; Kamler, M.; Berger, R.; Schmack, B.; Ruhparwar, A.; Popov, A.-F.; Weymann, A. The Impact of Obesity on Left Ventricular Assist Device Outcomes. Medicina 2020, 56, 556.

AMA Style

Zhigalov K, Sá MPBO, Arjomandi Rad A, Vardanyan R, Goerdt L, Chrosch T, Zubarevich A, Wendt D, Pizanis N, Koch A, Kamler M, Berger R, Schmack B, Ruhparwar A, Popov A-F, Weymann A. The Impact of Obesity on Left Ventricular Assist Device Outcomes. Medicina. 2020; 56(11):556.

Chicago/Turabian Style

Zhigalov, Konstantin, Michel P.B.O. Sá, Arian Arjomandi Rad, Robert Vardanyan, Lukas Goerdt, Thomas Chrosch, Alina Zubarevich, Daniel Wendt, Nikolaus Pizanis, Achim Koch, Markus Kamler, Rafal Berger, Bastian Schmack, Arjang Ruhparwar, Aron-Frederik Popov, and Alexander Weymann. 2020. "The Impact of Obesity on Left Ventricular Assist Device Outcomes" Medicina 56, no. 11: 556.

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