Laparoscopic sleeve gastrectomy in obese patients with ventricular assist devices

Published: 03-08-2020| Version 2 | DOI: 10.17632/8s35tzr33g.2
Contributors:
Adrian daSilva-deAbreu,
Kiran Garikapati,
Bader Aldeen Alhafez,
Sapna Desai,
Clement Eiswirth,
Hamang Patel,
Carl Lavie,
Hector O. Ventura,
juan Loro Ferrer,
Stacy A. Mandras,
Selim Krim

Description

We identified the patients with end-stage heart failure and ventricular assist devices (VADs) who underwent bariatric surgery at Ochsner Medical Center, the only center with a VAD program in the State of Louisiana, USA. Every patient underwent a comprehensive preoperative evaluation that included psychological, metabolic, nutritional, and cardiovascular assessments. All patients were over the age of 18 years and underwent laparoscopic sleeve gastrectomy (LSG) between 2016 and January 2020. All patients were on chronic antiplatelet and anticoagulation therapy with warfarin and aspirin. Both medications were held at the time of admission and heparin infusion was started until the midnight prior to LSG. If the INR was > 1.5 the evening prior to the surgery, the patient received fresh frozen plasma and then, the INR was remeasured in the morning prior to surgery, which was performed when the INR was ≤ 1.5. Provided that the patient developed no bleeding complication, heparin was started at 200 U/hr eight hours after LSG, increased to 400 U/hr during the postoperative day one. The following day, heparin was titrated to a goal thromboplastin time of 35-45 sec with addition of aspirin. On postoperative day three, the goal thromboplastin time was increased to 45-54 sec and warfarin was restarted at a dose of 1 mg. This dataset (database: LSG in patients with VADs) includes baseline, periprocedural, and outcome data, which are described in one of the attached documents (description of variables).

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