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Narvaez et al . Mini-invasive Surg 2020;4:31 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.22

Case Report Open Access

Use of an intra-aortic balloon pump during
laparoscopic sleeve gastrectomy

Andres Narvaez, Juan Esteban Perez, Melissa Castro, Keri A. Seymour
Department of Surgery, Duke University Health System, Division of Metabolic and Weight Loss Surgery, Durham, NC 27704,
USA.
Correspondence to: Assistant Prof. Keri A. Seymour, DO, FACS, Division of Metabolic and Weight Loss Surgery, Duke
University, 407 Crutchfield Street, Durham, NC 27704, USA. E-mail: keri.seymour@duke.edu

How to cite this article: Narvaez A, Perez JE, Castro M, Seymour KA. Use of an intra-aortic balloon pump during laparoscopic
sleeve gastrectomy. Mini-invasive Surg 2020;4:31. http://dx.doi.org/10.20517/2574-1225.2020.22

Received: 15 Feb 2020 First Decision: 30 Mar 2020 Revised: 13 Apr 2020 Accepted: 26 Apr 2020 Published: 16 May 2020
Science Editor: Wah Yang Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Heart transplant is the primary treatment for end-stage heart failure; however, morbid obesity limits candidacy.
Bariatric surgery performed in patients with advanced heart failure improves eligibility for heart transplantation.
This is the first report of an intra-aortic balloon pump used during laparoscopic sleeve gastrectomy. A patient
with morbid obesity and non-ischemic cardiomyopathy was referred for weight loss surgery prior to evaluation for
heart transplantation. An intra-aortic balloon pump was placed for aggressive diuresis and cardiovascular support
during laparoscopic sleeve gastrectomy. The patient did not suffer any complications or require readmission.
The use of an intra-aortic balloon pump as a mechanical circulatory system provided a safe laparoscopic sleeve
gastrectomy in a patient with advanced heart failure.

Keywords: Heart failure, sleeve gastrectomy, bariatric surgery, cardiac transplant

INTRODUCTION
Heart failure (HF) affects approximately 5.7 million adults in the United States with 5-year mortality
[1]
approaching 50% . Heart transplantation is the standard management for advanced HF. However, a
2
body mass index (BMI) ≥ 35 kg/m is associated with increased early complications, decreased long-
[2,3]
term survival, and lower likelihood of receiving an organ . Weight loss results in decreased vascular
stiffness and reduction in ventricular hypertrophy . Bariatric surgery in patients with advanced HF may
[4]
result in eligibility for heart transplantation. We report the use of an intra-aortic balloon pump (IABP)
for perioperative cardiovascular support during laparoscopic sleeve gastrectomy (LSG) in a patient with
advanced HF.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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