Bariatric surgery in patients with obesity and hypertrophic cardiomyopathy (HC), which has become more common in recent years, is safe and rarely associated with perioperative complications, according to findings published in The American Journal of Cardiology.
In this national trend evaluation study, researchers documented early outcomes of bariatric surgery for obesity in patients with HC. Using data from the National Inpatient Sample, 2011 to 2017, researchers identified 443 patients (61% women) with HC, 185 of whom had obstructive HC, who underwent elective bariatric surgery for obesity. The median age was 50 years, and 85 patients were aged 60 years or older. The only patients included in this study had a primary diagnosis of obesity and a secondary diagnosis of HC. In the 423 patients with a documented body mass index (BMI), 72% were greater than or equal to 40.0. Hyperlipidemia (54%), diabetes (50%), and systemic hypertension (42%) were present in the patients before the operation.
The 2 most common bariatric procedures were laparoscopic Roux-en-Y gastric bypass (25%) and laparoscopic sleeve gastrectomy (72%). The median hospital stay was 2 (IQR, 1-2) days. During the hospital stay, there were no reported deaths, myocardial infarctions, or episodes of thromboembolism. At the time of operation, just over 20% of the patients in this cohort had heart failure, 19% had atrial fibrillation, and 22% had an automatic cardiac defibrillator or pacemaker already implanted.
Limitations to this study included small sample size; only investigating inpatient bariatric surgery, which may not represent the same outcome in an outpatient setting; not measuring postoperative complications following hospital discharge; and the accuracy and completeness of the administrative data set used.
“[B]ariatric surgery is performed more frequently in obese patients with HC, and these procedures are safe and associated with few early postoperative complications,” the study authors wrote. “Because of the impact of obesity on long-term survival, bariatric surgery should be considered as an option for obese HC patients who do not respond to conservative weight loss measures.”
Sun D, Schaff HV, McKenzie TJ, et al. Safety of bariatric surgery in obese patients with hypertrophic cardiomyopathy. Am J Cardiol. Published online January 3, 2022. doi:10.1016/j.amjcard.2021.11.055