Bariatric surgery was found to be safe for patients with congestive heart failure (CHF), according to a study published in The American Surgeon.
In this retrospective study, the data of 41 patients with CHF included in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Center of Excellence database who underwent bariatric surgery between 2007 and 2018 were examined. Patients were assessed for clinical outcomes, reoperation, and mortality.
In this cohort, mean age was 55.8 years (range, 33-71 years), 51.2% were men, average body mass index was 51.8 kg/m2 (range, 38.1-80.2 kg/m2), 87.8% had hypertension, 80.5% obstructive sleep apnea, 63.4% osteoarthritis, 56.1% gastroesophageal reflux disease, and 53.7% diabetes mellitus.
All procedures were minimally invasive surgery (laparoscopic, 73.2%; robotic, 26.8%; sleeve gastrectomy, 39%; roux-en-Y gastric bypass, 26.8%; adjustable gastric band, 24.4%; removal of band to sleeve gastrectomy, 2.4%; removal of band to roux-en-Y gastric bypass, 2.4%; gastric band over gastric bypass pouch, 2.4%; and replacement of previous adjustable gastric band, 2.4%). Patients remained hospitalized for an average of 2.53 days (range, 1-13 days).
At 30 days, 2 patients (4.9%) were readmitted to the hospital after laparoscopic removal of gastric banding and roux-en-Y gastric bypass for shortness of breath and jejunojejunostomy, respectively. The patient in whom bowel obstruction occurred required exploratory laparotomy and decompression. The 30-day mortality rate was 2.4% (1 patient died from an unclear etiology 30 days after laparoscopic adjustable gastric band surgery).
This study was limited by its small sample size and absence of a comparison or control group. In addition, follow-up was restricted to 30 days, despite availability of 11 years of data. It also remains unclear to which extent patients benefitted clinically from their surgical procedures.
“The results of these studies seem to support the conclusion that bariatric surgery is reasonably safe and effective in obese patients with heart failure, although not
without some degree of risk,” concluded the study authors.
Brathwaite B M, Howell R S, Petrone P, et al. Safety of Bariatric Surgery in Patients With Congestive Heart Failure: Results of an 11-Year Retrospective Study. Am Surg. 2021;3134821991975. doi:10.1177/0003134821991975