Thursday, November 18, 2010

Bariatric Bypass Surgery

Bariatric Bypass Surgery
CHICAGO — A small study has found that morbidly obese patients with HF who undergo bariatric surgery gain long-lasting and meaningful improvements in disease symptoms and quality of life.

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“This tells us that bariatric surgery may become part of the treatment of patients with HF and obesity if there are no major contraindications for the surgery — and that this might be especially important for patients with significant obesity,” Francisco Lopez-Jiminez, MD, said in a press release.

The study results were presented at the American Heart Association Scientific Sessions 2010.

Lopez-Jiminez cautioned, however, that because the study tested the effects of bariatric surgery on just 13 patients, “these results should be considered preliminary and suggestive of some benefit, but additional research is needed to confirm these results.”

It appears that cardiologists do not often refer obese patients with HF for bariatric surgery, despite statistics showing that one-third of HF patients are obese, Lopez-Jiminez said.

The researchers reviewed the outcomes of 13 patients, aged 44 to 64 years, who underwent bariatric surgery at Mayo Clinic in Minnesota between 1990 and 2005, as well as six HF patients, aged 52 to 72, who were followed at the Mayo Nutrition Clinic and did not receive the surgery.

In the group that received surgery, the mean BMI was 53, and in the comparison group, it was 42. After 4 years of follow-up, the mean BMI dropped in the surgery group to 37 and rose in the comparison group to 45.

Based on patient surveys, the researchers found that quality of life was significantly improved in those who received weight-loss surgery, compared with HF patients who did not. Researchers also determined that symptoms such as swelling in the legs and labored breathing during exercise improved only in the surgery group.

Lopez-Jimenez said that the health advantages seen in the patients who had bariatric surgery occurred even though most remained obese.

“These patients had very advanced levels of obesity before the surgery, and although they lost significant amounts of weight, most remained obese. So, these good results suggest that the benefit does not require patients to reach a normal weight,” he said.