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See Latest ArticlesCardiovascular evaluation and management of severely obese patients undergoing surgery. A science advisory from the American Heart Association
Circulation, 06/17/09
Poirier P et al. – An American Heart Association science advisory on cardiovascular evaluation and management of severely obese surgical pts summarizes recommendations for preoperative cardiovascular evaluation, intraoperative and perioperative management, and postoperative cardiovascular care of this increasingly prevalent pt population.
Methods- Summary of an American Heart Association science advisory for cardiovascular evaluation and management of severely obese surgical pts
- Risk of adverse perioperative cardiac event in obese pts relates to nature and severity of underlying heart disease, associated comorbidities, and type of surgery
- Severe obesity not associated with increased mortality in cardiac surgery pts
- Severe obesity associated with increased length of hospital stay and greater likelihood of renal failure and prolonged assisted ventilation
- Comorbidities influencing preoperative cardiac risk assessment of these pts: presence of therosclerotic cardiovascular disease, heart failure, systemic hypertension, pulmonary hypertension related to sleep apnea and hypoventilation, cardiac arrhythmias (primarily atrial fibrillation), and deep vein thrombosis
- Considerations for preoperative risk evaluation: risk, age, gender, cardiorespiratory fitness, electrolyte disorders, and heart failure as independent predictors for surgical morbidity and mortality
- Proposal of an obesity surgery mortality score for gastric bypass
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