@article{54032acf279f4fb9a8acec31b362d3ba,
title = "Outcomes of Severely Obese Patients Supported by a Centrifugal-Flow Left Ventricular Assist Device: Outcomes of HVAD Patients With Severe Obesity",
abstract = "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.",
keywords = "Left ventricular assist device, obesity, patient outcomes",
author = "Kiernan, {Michael S.} and Najjar, {Samer S.} and Vest, {Amanda R.} and Birks, {Emma J.} and Nir Uriel and Ewald, {Gregory A.} and Katrin Leadley and Patel, {Chetan B.}",
note = "Funding Information: M.S.K. is a consultant for Medtronic and has received travel grant from Abbott. S.S.N. receives research grant support from and is on the advisory board for Medtronic. E.J.B. receives research grant support from Medtronic and Abbott. N.U. is a consultant for Medtronic, Abbott, and XDx Inc. G.A.E. is a consultant for Medtronic. K.L. was an employee of Medtronic. C.B.P. receives conference fee support from Medtronic and Abbott. None of the other authors have a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose. The authors acknowledge Ming-Jay Chow, Medtronic Inc, for his assistance in the preparation of the manuscript. Funding Information: M.S.K. is a consultant for Medtronic and has received travel grant from Abbott. S.S.N. receives research grant support from and is on the advisory board for Medtronic . E.J.B. receives research grant support from Medtronic and Abbott. N.U. is a consultant for Medtronic , Abbott, and XDx Inc. G.A.E. is a consultant for Medtronic . K.L. was an employee of Medtronic . C.B.P. receives conference fee support from Medtronic and Abbott. None of the other authors have a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",
year = "2020",
month = feb,
doi = "10.1016/j.cardfail.2019.10.013",
language = "English",
volume = "26",
pages = "120--127",
journal = "Journal of cardiac failure",
issn = "1071-9164",
number = "2",
}