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  • Title: Cardiac surgery and morbid obesity.
    Author: Uva MS, Rodrigues V, Monteiro N, Manuel Pedro A, Caria R, Mesquita A, Fernandes J, Pinho J, Bau J, Magalhães P.
    Journal: Rev Port Cardiol; 2002 Mar; 21(3):255-64; discussion 267-9. PubMed ID: 12017800.
    Abstract:
    OBJECTIVE: Obesity is considered a risk factor for the occurrence of complications after cardiac surgery. The objective of this study was to analyze mortality and morbidity in patients with morbid obesity following heart surgery. DESIGN: Retrospective study in a tertiary care setting. METHODS: Out of 1815 adult patients undergoing cardiac surgery, 50 consecutive patients (3%) with morbid obesity (defined by a body mass index (BMI) > 35 kg/m2) operated on between 7/98 and 3/01 were studied. Mean age was 61.9 +/- 10.4 years, mean BMI was 38.0 +/- 2.7 kg/m2 and mean Parsonnet score was 14.3. Thirty patients had CABG, 14 underwent valve surgery and 6 had combined valve and CABG. RESULTS: Three patients died in the first 30 days (hospital mortality = 6%). Four patients had myocardial infarction (8%), 4 patients had stroke (8%) and 13 required blood transfusion (29%). There were no deep sternal wound infections or reoperations but 9 patients (15%) presented superficial wound infections. Mean ICU and hospital stay were 2.2 +/- 2.2 and 6.8 +/- 4.1 days respectively. With a mean follow up of 13.9 +/- 8.9 months, 4 patients died; 38 (93%) out of the 41 patients reviewed are in NYHA class I or II and 27 (65%) have unrestricted physical activity. CONCLUSIONS: Cardiac surgery in patients with morbid obesity carries a higher morbidity and mortality risk. Short- and medium-term results were satisfactory with improvement in quality of life in two-thirds of the patients.
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