Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure
Year: 2008
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Morbid obesity (MO) is a risk factor for congestive heart failure (CHF). The presence of MO impairs functional status and disqualifies patients for cardiac transplantation. Bariatric surgery (BAS) is a frontline, durable treatment for MO; however, the safety and efficacy of BAS in advanced CHF is unknown. HYPOTHESIS: We hypothesized that by utilizing a coordinated approach between an experienced surgical team and heart failure specialists, BAS is safe in patients with advanced systolic CHF and results in favorable outcomes. METHODS: We performed a retrospective chart review of 12 patients with MO (body mass index [BMI] 53 +/- 7 kg/m2) and systolic CHF (left ventricular ejection fraction [LVEF] 22 +/- 7%, New York Heart Association [NYHA] class 2.9 +/- 0.7) who underwent BAS, and then compared outcomes with 10 matched controls (BMI 47.2 +/- 3.6 kg/m2, LVEF 24 +/- 7%, and NYHA class 2.4 +/- 0.7) who were given diet and exercise counseling. RESULTS: At 1 y, hospital readmission in BAS patients was significantly lower than controls (0.4 +/- 0.8 versus 2.5 +/- 2.6, p = 0.04); LVEF improved significantly in BAS patients (35 +/- 15%, p = 0.005), but not in controls (29 +/- 14%, p = not significant [NS]). The NYHA class improved in BAS patients (2.3 +/- 0.5, p = 0.02), but deteriorated in controls (3.3 +/- 0.9, p = 0.02). One BAS patient was successfully transplanted, and another listed for transplantation. CONCLUSIONS: Bariatric surgery is safe and effective in patients with MO and severe systolic CHF, and should be considered in patients who have failed conventional therapy to improve clinical status.
Source: Clinical Cardiology
DOI: 10.1002/clc.20315
Institution: University of Pittsburgh Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2044665227