Improving the Odds of Benefitting from Advanced Therapies: Lifestyle, Exercise, and Medical/Surgical Weight Loss Interventions

Malnutrition, obesity, frailty, and deconditioning are important risk factors for patients with heart failure undergoing advanced therapies, including LVAD and OHT. Identifying and treating these conditions may improve the likelihood of successful transplant or LVAD outcomes.

We will first discuss how to identify frailty in heart failure patients, examining its impact on prognosis and implications for advanced therapy considerations. Next, the importance of, and strategies for, prehabilitation in both ambulatory and inpatient settings will be reviewed. We will also discuss current methods to assess malnutrition in patients with advanced heart failure, as well as approaches to improve nutritional status, ranging from targeted dietary interventions and supplementation to strategies that address underlying metabolic derangements.

Finally, we will explore medical and surgical interventions to address obesity prior to advanced therapies, focusing on the right candidate, right time, and right intervention.

Learning Objectives

• Describe frailty risk assessments in clinical practice and their implications for advanced therapy considerations.
• Understand the role of prehabilitation and nutrition optimization before cardiac surgery for LVAD/OHT.
• Review medical and surgical options to treat obesity prior to cardiac surgery for LVAD/OHT.