One in three Americans are overweight, which has created a crisis of life-threatening complications from obesity, such as high blood pressure, stroke, diabetes and cardiac disease.
Ivan Martinez Diez-Muro, a health sciences student at USF鈥檚 (COPH), wants to play a part in reversing this chronic problem when he becomes a medical doctor. By understanding pioneering surgery techniques and technologies, Diez-Muro hopes to improve the lives of severely obese people.
He recently shared an aspect of his study in a poster essay Sleeve Gastrectomy in an LVAD Patient: Bridge to Cardiac Transplant, which he presented at a Palm Beach County Medical Society symposium. The title refers to a surgical procedure for weight loss that involves removing about 80 percent of the stomach of patients who also wear a special pump to support their heart.
鈥淲hen I was shadowing my first doctor, who was a bariatric surgeon, I had the opportunity to observe an incredible case: a 28-year-old patient who had end-stage heart failure,鈥欌€� Diez-Muro said. 鈥淭his experience sparked my interest in the topic of obesity and the LVAD device. I found it amazing that the patient was wearing a device that was keeping her alive.鈥欌€�
LVAD stands for 鈥渓eft ventricular assist device,鈥欌€� a small, battery-operated motor implanted in the ventricle that pumps blood into the aorta, the main artery carrying blood to the body. It can be adjusted to provide different levels of assistance, depending on the patient's needs.
LVAD is not a cure for heart disease; rather, it serves as a bridge to a heart transplant or provides long-term support when a transplant isn鈥檛 possible. Although LVAD technology first appeared in 1962, today鈥檚 models are more compact, robust and effective. Modern benefits include employ biocompatible materials, wireless power transmission, remote patient management, extended battery life and minimally invasive implant techniques. This translates to better patient outcomes and quality of life.
The person in Diez-Muro鈥檚 case study suffered from class III obesity, a body mass index (BMI) of 48, which is called morbid obesity (a BMI of 30 is considered obese). She was diagnosed with non-ischemic cardiomyopathy, a heart muscle disease that weakens the organ鈥檚 ability to pump blood. In part due to her weight, she received the LVAD.
At six months following surgery, the patient achieved a BMI reduction of 11 points 鈭� a 60-pound weight loss. She continued her efforts with diet and exercise and participates in cardiac rehabilitation three days per week.
As part of his studies and experience in medicine, he recently started working for 91社区 Medical Clinic Orlando Health as a medical scribe for a cardiologist, and has volunteered for more than 100 hours caring for people with non-medical needs. He hopes to decide on a specific medical path soon.
"The human body and heart have always captivated me,'' he said. "I've always enjoyed cardiology, but I realize it's a little early to choose a specialty.''
In the United States, obesity is estimated to cause between 280,000 and 374,000 deaths each year and more than $170 billion in medical expenses, according to the Centers for Disease Control and Prevention. This is why the sleeve surgery and LVAD are important weapons in the war on obesity and related heart disease, Diez-Muro said.
鈥淎 healthy heart and a balanced weight are not achieved through quick fixes but through a sustained effort,鈥欌€� he said. 鈥淚 want to emphasize how bariatric surgery and LVAD help patients with end-stage heart disease, which is a potentially fatal consequence of obesity. Along with weight loss strategies, including dietary and surgical interventions, their chances increase for new heart transplants.鈥欌€�