Background

Patients with morbid obesity have a two-fold risk of multi-organ dysfunction, one of which being congestive heart failure. Patients with congenital heart disease (CHD) or congestive heart failure (CHF) in need of cardiac intervention are often excluded secondary to BMI. We aim to demonstrate perioperative outcomes in patients with morbid obesity and underlying cardiac dysfunction who undergo laparoscopic sleeve gastrectomy (LSG).

Results

A total of 45 patients who underwent LSG between November 2017 and September 2022 were included. Cardiac dysfunction in these patients was represented by: CHF (79.1%), cardiomyopathy (69.8%), CHD (16.3%), history of STEMI or NSTEMI (14.0%), valvular disease (7%), endocarditis (2.3%), and myocarditis (2.3%). Twelve patients (26.7%) had a left ventricular assist device (LVAD) in place preoperatively. The mean preoperative BMI was 47.95 (SD: 7.97). Within one-year post-operatively, NYHA score for patients improved across all four classes. Eight patients (17.8%) qualified for transplant, and four (8.9%) of these received a heart transplant. NYHA score for the cohort was decreased preoperatively from the following classes: 8.1%, Class I 43.2%, Class II, 37.8% Class III , 10.8% Class IV to the following values 1 year postoperatively: 34.5% Class I , 37.9% Class II , 20.7% Class III, 6.9% Class IV.

Conclusions

LSG is safe to perform in patients with underlying cardiac disease and may offer patients with obesity the opportunity to pursue cardiac transplant, improve NYHA score and, subsequently, cardiac functionality. This may offer patients with heart failure and LVAD an increase in quality of life.