From the Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan.
ASAIO J. 2024 Oct 1;70(10):e142-e146. doi: 10.1097/MAT.0000000000002162. Epub 2024 Feb 12.
Durable left ventricular assist devices (LVADs) are a well-established therapeutic option for patients with advanced heart failure. These devices are often used to "bridge" patients to an orthotopic heart transplantation (HT). Unfortunately, many patients on LVAD support with a body mass index (BMI) above a certain value are not eligible for HT due a lack of suitable donors and the association between obesity and poor outcomes after HT. This case series describes three individuals on LVAD support who were able to successfully lose enough weight to qualify to be listed for an HT. We highlight a systematic, multidisciplinary approach to implementing guideline-driven weight loss strategies, including some aggressive methods ( ie , meal replacements, weight loss medications, and bariatric surgery). In addition to describing the weight loss outcomes, we also discuss barriers and medical challenges during weight loss that are unique to this population.
耐用型左心室辅助装置（LVAD）是治疗晚期心力衰竭患者的一种成熟的治疗选择。这些装置通常用于“桥接”患者接受原位心脏移植（HT）。不幸的是，许多 BMI 值超过一定值的 LVAD 支持患者由于缺乏合适的供体以及肥胖与 HT 后不良结果之间的关联而不符合 HT 条件。本病例系列描述了 3 名接受 LVAD 支持的个体，他们成功地减轻了足够的体重，有资格接受 HT。我们强调了一种系统的、多学科的方法来实施指南驱动的减肥策略，包括一些激进的方法（例如，代餐、减肥药物和减重手术）。除了描述减肥结果外，我们还讨论了在减肥过程中针对该人群特有的障碍和医疗挑战。
