Safety and efficacy of bariatric surgery in morbidly obese patients with severe systolic heart failure
Open accessAbstract
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/m 2) 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/m 2, 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. Copyright © 2008 Wiley Periodicals, Inc.
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A recent small study suggests that bariatric surgery is safe and effective for patients with severe systolic heart failure.
“a recent small study suggests that bariatric surgery is safe and effective in patients with severe systolic HF (87).”
From Obesity and Cardiovascular Disease (2009) · cites this paper as [87]
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- Authors
- Ramani, G. V., McCloskey, C., Ramanathan, R. C., & Mathier, M. A.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Ramani, Gautam V.
- ORCID
- Ramani, Gautam V.
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 2008-11
- Volume
- 31
- Issue
- 11
- Pages
- 516-520
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- PMC
- PMC6652810
- OpenAlex
- W2044665227
- Cited by
- 123
- References
- 24
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 2 · 2021: 11 · 2020: 17 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 13 · 2015: 9 · 2014: 5 · 2013: 8 · 2012: 6
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Cardiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- bariatric surgery, morbid obesity, heart failure with reduced ejection fraction, congestive heart failure, left ventricular ejection fraction, heart transplantation, hospital readmission, NYHA functional class
- MeSH terms
- Adult, Female, Heart Failure, Humans, Male, Middle Aged, Obesity, Morbid, Retrospective Studies, Cohort Studies, Body Mass Index, Case-Control Studies, Ventricular Function, Left, Bariatric Surgery, Heart Failure, Systolic
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