Abstract | BACKGROUND: 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.
|
Authors | Gautam V Ramani, Carol McCloskey, Ramesh C Ramanathan, Michael A Mathier |
Journal | Clinical cardiology
(Clin Cardiol)
Vol. 31
Issue 11
Pg. 516-20
(Nov 2008)
ISSN: 0160-9289 [Print] United States |
PMID | 19006115
(Publication Type: Journal Article)
|
Copyright | Copyright 2008 Wiley Periodicals, Inc. |
Topics |
- Adult
- Bariatric Surgery
(adverse effects, methods)
- Body Mass Index
- Case-Control Studies
- Cohort Studies
- Female
- Heart Failure
(etiology)
- Heart Failure, Systolic
(etiology, physiopathology)
- Humans
- Male
- Middle Aged
- Obesity, Morbid
(complications, physiopathology, surgery)
- Retrospective Studies
- Ventricular Function, Left
|