Original ArticleImpact of Laparoscopic Sleeve Gastrectomy on Cardiovascular Pharmacotherapy in Left Ventricular Assist Device PatientsAl-Ani, Mohammad A. MD*; Murray, Melissa R. PharmD†; Taha, Mohamad Badie MD‡; Meece, Lauren APRN§; Elsayed, Abdelrahman H. PhD¶; Jeng, Eric I. MD‖; Arnaoutakis, George J. MD‖; Wu, Yu DNP**; Friedman, Jeffrey E. MD††; Vilaro, Juan R. MD*; Parker, Alex M. MD*; Aranda, Juan M. Jr MD*; Ahmed, Mustafa M. MD* Author Information *Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL; †Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, FL; ‡Department of Medicine, University of Florida College of Medicine, Gainesville, FL; §University of Florida College of Medicine, Gainesville, FL; ¶Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, Gainesville, FL; ‖Division of Thoracic and Cardiovascular Surgery, University of Florida College of Medicine, Gainesville, FL; **University of California at San Francisco, San Francisco, CA; and ††Division of Minimally Invasive Surgery, University of Florida College of Medicine, Gainesville, FL. Correspondence: Mohammad A. Al-Ani, MD, Division of Cardiology, Department of Medicine, University of Florida, 1329 SW 16th St, Suite 5130, PO Box 100288, Gainesville, FL 32608 (e-mail: [email protected]). The authors report no conflicts of interest. Journal of Cardiovascular Pharmacology: May 2022 - Volume 79 - Issue 5 - p 646-649 doi: 10.1097/FJC.0000000000001223 Buy Corresponding Article Metrics Abstract Left ventricular assist device (LVAD) implantation is increasingly utilized in patients with advanced heart failure and morbid obesity. Laparoscopic sleeve gastrectomy (LSG) can facilitate weight loss in this population and can ultimately change the pharmacokinetics of heart failure therapeutics. In this study, we aimed to explore the changes in cardiovascular pharmacotherapy post LSG intervention. We conducted a retrospective observational cohort study of morbidly obese LVAD patients between 2013 and 2019 at the University of Florida with available pharmacotherapeutic data at 1 and 6 months. Thirteen post-LSG patients and 13 control subjects were included in the final analysis. In the post-LSG group, the mean body mass index decreased significantly (44 ± 5 vs. 34 ± 4.9, P < 0.001), and 7 patients were successfully bridged to cardiac transplantation. Only 3 patients required adjustment of their LVAD speed. Mean return to flow decreased by 8 mm Hg, despite a 45% reduction in the mean number of vasodilators per patient (1.2 vs. 0.7, P = 0.03). Mean weekly warfarin dose decreased by 35% after 6 months (32.9 ± 20.9 vs. 50.7 ± 26.6, P = 0.01). The use of diuretics, vasodilators, and beta-blockers was significantly reduced by 50%, 45%, and 35%, respectively. None of these changes were observed in the control group at 6-month follow-up post LVAD. In this single-center experience, weight loss post LSG is associated with decreased vasodilator, diuretic, and anticoagulant medication requirements in LVAD patients. Corresponding Article Sleeve Gastrectomy Reduces BMI and Pill Count in Patients With LVAD Billingsley, Hayley; Dixon, Dave; Yehya, Amin; Carbone, Salvatore; Abbate, Antonio Journal of Cardiovascular Pharmacology. 79(5):644-645, May 2022. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.