PMID- 19006115
OWN - NLM
STAT- MEDLINE
DCOM- 20090227
LR  - 20211020
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 31
IP  - 11
DP  - 2008 Nov
TI  - Safety and efficacy of bariatric surgery in morbidly obese patients with severe 
      systolic heart failure.
PG  - 516-20
LID - 10.1002/clc.20315 [doi]
AB  - 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.
CI  - Copyright 2008 Wiley Periodicals, Inc.
FAU - Ramani, Gautam V
AU  - Ramani GV
AD  - Cardiovascular Institute, University of Pittsburgh Medical Center Pittsburgh, PA 
      15213, USA. gvr001@yahoo.com
FAU - McCloskey, Carol
AU  - McCloskey C
FAU - Ramanathan, Ramesh C
AU  - Ramanathan RC
FAU - Mathier, Michael A
AU  - Mathier MA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Adult
MH  - *Bariatric Surgery/adverse effects/methods
MH  - Body Mass Index
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure/etiology
MH  - Heart Failure, Systolic/etiology/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*complications/physiopathology/*surgery
MH  - Retrospective Studies
MH  - Ventricular Function, Left
PMC - PMC6652810
EDAT- 2008/11/14 09:00
MHDA- 2009/02/28 09:00
PMCR- 2008/11/12
CRDT- 2008/11/14 09:00
PHST- 2008/11/14 09:00 [pubmed]
PHST- 2009/02/28 09:00 [medline]
PHST- 2008/11/14 09:00 [entrez]
PHST- 2008/11/12 00:00 [pmc-release]
AID - CLC20315 [pii]
AID - 10.1002/clc.20315 [doi]
PST - ppublish
SO  - Clin Cardiol. 2008 Nov;31(11):516-20. doi: 10.1002/clc.20315.