Division of Gastroenterology and Hepatology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road S., Jacksonville, FL, 32224, USA.
Obes Surg. 2020 Sep;30(9):3610-3614. doi: 10.1007/s11695-020-04572-7.
Obesity is an important limiting factor for heart transplantation (HT) in patients with congestive heart failure (CHF). Achieving substantial weight loss is challenging in this population due to activity limitations and fluid retention. Endoscopic bariatric therapies (EBTs) including intragastric balloons (IGB) are effective primary weight loss therapies. IGBs have also been successfully utilized as a bridge therapy prior to liver transplantation and, in one case report, prior to HT. Potential advantages of IGBs in this population include low bleeding risk and less invasiveness as compared to other EBTs and surgery. We report the successful use of IGB as a bridge therapy in two patients with class II obesity and end-stage CHF requiring left ventricular assist devices (LVAD), anticoagulation, antiplatelet, and inotrope therapy.
肥胖症是充血性心力衰竭（CHF）患者心脏移植（HT）的一个重要限制因素。由于活动受限和液体潴留，该人群很难实现显著的体重减轻。内镜减重治疗（EBT）包括胃内球囊（IGB），是有效的原发性减重治疗方法。IGB 也已成功用作肝移植前的桥接治疗，在一个病例报告中，也用作 HT 前的桥接治疗。与其他 EBT 和手术相比，IGB 在该人群中的潜在优势包括较低的出血风险和较少的侵袭性。我们报告了在两名患有 II 类肥胖症和终末期 CHF 需要左心室辅助装置（LVAD）、抗凝、抗血小板和正性肌力治疗的患者中成功使用 IGB 作为桥接治疗的情况。
