Background

Many congestive heart failure (CHF) patients are denied cardiac transplants due to inability to meet transplantation BMI criteria. Bariatric intervention, including surgery, medication, and weight-loss guidance, may help patients lose weight and become eligible for transplantation. One major concern is the ability to safely operate on this population due to reduced cardiac function, increased BMI, and other comorbidities. Our prospective cohort study examined the efficacy of bariatric intervention for 18 patients with CHF and BMI >30 as a bridge to cardiac transplantation. Interventions included Sleeve Gastrectomy (n=6), Roux-en-Y Gastric Bypass (n=1), or medical/lifestyle weight loss (n=11). Patients studied were ACCF stages B-D and NYHA class 2-4 with most patients at stage C and class 3. Average patient weight before bariatric intervention was 292.5 lbs and average BMI was 42.5 (Table 1). At six months post-intervention, patients lost an average of 19.3 lbs and decreased their BMI by 2.8 points. The average left ventricular ejection fraction (LVEF) before bariatric intervention was 20.9%, which increased to an average of 26.1% approximately six months after intervention. One patient received a cardiac transplant. Initial results of our study suggest that bariatric intervention among this cohort may be beneficial as bridge therapy to cardiac transplantation. This study is ongoing, and future direction may include additional patient recruitment, further tracking of weight loss and cardiac function, and analysis surrounding eventual cardiac transplantation.