Is Bariatric Surgery Safe for Obese Patients with Heart Conditions?

Q: Is Bariatric Surgery Safe for Obese Patients with Heart Conditions?

A person without dreams： Height 147 cm, weight 145 kg, has reached the level of morbid obesity. <br>It is recommended to visit a family medicine clinic to evaluate whether there are endocrine issues, dietary habits, exercise deficiencies, or poor lifestyle choices contributing to

Overweight

Hello Dr.
Huang: A while ago, I was hospitalized at your facility, but I feel that my treatment was not very effective.
During my over one-month stay, I only saw a doctor 3 to 4 times, was advised to eat meal replacements, and did not undergo any specific tests.
The reasons are simple.
My medical conditions include: cardiomegaly, ischemic heart disease, hypertension, and abdominal lipomas.
I am 147 cm tall and weigh 145 kg, but I am taking my medications as prescribed.
Can someone with my level of obesity undergo gastric sleeve surgery? Is there any risk involved?

Mei You Meng De Ren, 40~49 year old female. Ask Date: 2004/09/20

Dr. Huang Jianling reply Family Medicine

A person without dreams: Height 147 cm, weight 145 kg, has reached the level of morbid obesity.
It is recommended to visit a family medicine clinic to evaluate whether there are endocrine issues, dietary habits, exercise deficiencies, or poor lifestyle choices contributing to the obesity.
You can find information related to gastric sleeve surgery at the following website: En Chu Kong Hospital - Laparoscopic Weight Loss Surgery Center http://www.obesity.idv.tw/contents/operation.htm.
Sincerely, Dr.
Huang Jian-Ling.

Reply Date: 2004/09/20

More Info

Bariatric surgery, particularly sleeve gastrectomy or gastric bypass, can be a viable option for obese patients, even those with pre-existing heart conditions. However, the decision to proceed with such surgery must be carefully evaluated by a multidisciplinary team, including cardiologists, bariatric surgeons, and other specialists.
Given your medical history of heart enlargement, ischemic heart disease, hypertension, and the presence of a lipoma, it is crucial to assess the overall risk versus benefit of undergoing bariatric surgery. Obesity itself is a significant risk factor for various cardiovascular diseases, and weight loss can lead to improvements in heart function, blood pressure, and overall health. However, the presence of heart conditions complicates the situation.

Safety Considerations
1. Cardiac Evaluation: Before considering bariatric surgery, a thorough cardiac evaluation is essential. This may include echocardiograms, stress tests, and possibly cardiac catheterization to assess the current state of your heart. The goal is to ensure that your heart can tolerate the stress of surgery and the subsequent recovery period.

2. Surgical Risks: Bariatric surgery carries inherent risks, including complications from anesthesia, infection, and potential cardiovascular events during or after the procedure. For patients with heart conditions, these risks may be elevated. The surgical team will need to weigh these risks against the potential benefits of significant weight loss.

3. Postoperative Care: After bariatric surgery, patients often experience rapid weight loss, which can lead to improvements in heart health. However, close monitoring is necessary during the recovery phase. Patients with heart conditions may require adjustments in their medications and careful management of their cardiovascular health post-surgery.

4. Lifestyle Changes: Bariatric surgery is not a standalone solution. It requires a commitment to lifestyle changes, including dietary modifications and regular physical activity. For patients with heart conditions, a tailored exercise program should be developed in consultation with a healthcare provider.

5. Long-term Follow-up: Regular follow-up with both the bariatric team and cardiologists is essential to monitor weight loss progress, nutritional status, and cardiovascular health. This ongoing care can help mitigate potential complications and ensure that both weight loss and heart health are optimized.

Conclusion
In summary, while bariatric surgery can be safe for obese patients with heart conditions, it requires careful consideration and a comprehensive evaluation of your overall health status. It is crucial to have open discussions with your healthcare providers about your concerns, the potential risks, and the expected benefits of the surgery. If you are considering this option, seek a center that specializes in bariatric surgery for patients with comorbidities, as they will have the experience and resources to manage complex cases effectively.
Ultimately, the decision should be made collaboratively, ensuring that all aspects of your health are taken into account, and that you feel comfortable and informed about the path forward.

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