Bariatric surgery in patients with pulmonary hypertension

Bariatric surgery in patients with pulmonary hypertension

Data regarding the outcomes of bariatric surgery in patients with pulmonary hypertension (PH) is limited. The aim of this study was to review our experience on bariatric surgery in patients with PH. An academic medical center. Patients with PH who underwent either a primary or revisional bariatric s...

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Bibliographic Details
Published in:Surgery for obesity and related diseases Vol. 14; no. 10; pp. 1581 - 1586
Main Authors: Hanipah, Zubadiah Nor, Mulcahy, Michael J., Sharma, Gautam, Punchai, Suriya, Steckner, Karen, Dweik, Raed, Aminian, Ali, Schauer, Philip R., Brethauer, Stacy A.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-10-2018
Subjects:
Bariatric surgery
Bariatric Surgery - adverse effects
Bariatric Surgery - statistics & numerical data
Body Mass Index
Female
Gastric bypass
Humans
Hypertension, Pulmonary - complications
Male
Middle Aged
Multiple Chronic Conditions
Obesity
Obesity - complications
Obesity - physiopathology
Obesity - surgery
Postoperative Complications - etiology
Pulmonary hypertension
Retrospective Studies
Risk Factors
Sleeve gastrectomy
Weight Loss - physiology
Obesity
Pulmonary hypertension
Bariatric surgery
Gastric bypass
Sleeve gastrectomy
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Summary:Data regarding the outcomes of bariatric surgery in patients with pulmonary hypertension (PH) is limited. The aim of this study was to review our experience on bariatric surgery in patients with PH. An academic medical center. Patients with PH who underwent either a primary or revisional bariatric surgery between 2005 and 2015 and had a preoperative right ventricle systolic pressure (RVSP) ≥35 mm Hg were included. Sixty-one patients met the inclusion criteria. Fifty (82%) were female with the median age of 58 years (interquartile range [IQR] 49–63). The median body mass index was 49 kg/m2 (IQR 43–54). Procedures performed included the following: Roux-en-Y gastric bypass (n = 33, 54%), sleeve gastrectomy (n = 24, 39%), adjustable gastric banding (n = 3, 5%), and banded gastric plication (n = 1, 2%). Four patients (7%) underwent revisional bariatric procedures. Median operative time and length of stay was 130 minutes (IQR 110–186) and 3 days (IQR 2–5), respectively. The 30-day complication rate was 16% (n = 10) with pulmonary complications noted in 4 patients. There was no 30-day mortality. One-year follow-up was available in 93% patients (n = 57). At 1 year, median body mass index and excess weight loss were 36 kg/m2 (IQR 33–41) and 51% (IQR 33–68), respectively. There was significant improvement in the RVSP after bariatric surgery at a median follow-up of 22 months (IQR 10–41). The median RVSP decreased from 44 (IQR 38–53) to 40 mm Hg (IQR 28–54) (P = .03). Bariatric surgery can be performed without prohibitive complication rates in patients with PH. In our experience, bariatric patients with PH achieved significant weight loss and improvement in RVSP.
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ISSN:1550-7289
1878-7533
DOI:10.1016/j.soard.2018.07.015