Outcomes of Severely Obese Patients Supported by a Centrifugal-Flow Left Ventricular Assist Device.

Published online

Journal Article

BACKGROUND: Ventricular assist devices provide improved outcomes for patients with advanced heart failure, but their benefit in the severely obese is not well documented. METHODS: Patients enrolled in the HeartWare ADVANCE trial (n=382) were divided into 2 body mass index (BMI) groups. Patients with severe obesity (>35 kg/m2) were compared with a control group with BMI ≤35 kg/m2. The association of BMI with survival was tested using Kaplan-Meier analysis and major adverse events were compared. RESULTS: At implantation, 48 (13%) of patients were severely obese. There was no difference in survival through 2 years of support between severely obese patients and the control group. Severely obese patients were at higher risk of driveline infection (P = .01) and acute renal dysfunction (P = .002). Both groups experienced similar improvements in quality of life. Functional capacity improved in both severely obese and control patients, although severely obese patients had smaller improvements than controls in their 6-minute walk scores. CONCLUSIONS: Despite an increased risk of adverse events, severe obesity was not associated with reduced survival or quality of life. A better understanding of the risks and benefits of left ventricular assist device therapy in obese patients will help in the shared decision-making of the patient selection process.

Full Text

Duke Authors

Cited Authors

  • Kiernan, MS; Najjar, SS; Vest, AR; Birks, EJ; Uriel, N; Ewald, GA; Leadley, K; Patel, CB

Published Date

  • November 5, 2019

Published In

PubMed ID

  • 31704196

Pubmed Central ID

  • 31704196

Electronic International Standard Serial Number (EISSN)

  • 1532-8414

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2019.10.013

Language

  • eng

Conference Location

  • United States