减重手术与心力衰竭患者左心室辅助装置：系统评价和荟萃分析。
Bariatric surgery and left ventricular assist device in patients with heart failure: A systematic review and meta-analysis.
机构信息
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
St George's University of London, London, SW17 0RE, UK.
出版信息
Am J Surg. 2023 Sep;226(3):340-349. doi: 10.1016/j.amjsurg.2023.06.014. Epub 2023 Jun 17.
BACKGROUND
The role of metabolic and bariatric surgery (MBS), in synergy with left ventricular assist device (LVAD) implantation, in the scope of end-stage heart failure management for patients with severe obesity is not well elucidated.
METHODS
We conducted a meta-analysis using Cochrane, Embase, PubMed, and Scopus databases to include articles from their inception to November 2022.
RESULTS
A total of 271 patients who underwent MBS during or after the LVAD implantation were included from eleven separate studies. After surgery, 67.4% of patients were listed on the heart transplant waitlist with 32.5% undergoing a successful transplant. We reported a mean listing time of 13.8 months. Finally, the pooled postoperative complication rate, 30-day readmission rate, and one-year mortality rate were 47.6%, 23.6% and 10.2% respectively.
CONCLUSIONS
MBS and LVAD is a safe and effective approach to bridge patients with severe obesity and end-stage heart failure for definitive heart transplantation.
背景
代谢和减重手术（MBS）与左心室辅助装置（LVAD）植入协同作用，在严重肥胖的终末期心力衰竭患者的管理中具有重要作用，但目前其作用尚未完全阐明。
方法
我们使用 Cochrane、Embase、PubMed 和 Scopus 数据库进行了一项荟萃分析，纳入了从数据库建立到 2022 年 11 月的文章。
结果
从 11 项单独的研究中纳入了总共 271 例在 LVAD 植入期间或之后接受 MBS 的患者。手术后，67.4%的患者被列入心脏移植等待名单，其中 32.5%的患者成功进行了移植。我们报告的平均列入时间为 13.8 个月。最后，术后并发症发生率、30 天再入院率和 1 年死亡率的汇总值分别为 47.6%、23.6%和 10.2%。
结论
MBS 和 LVAD 是一种安全有效的方法，可以为严重肥胖和终末期心力衰竭患者桥接，以进行确定性心脏移植。
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