Is obesity still a risk factor for patients undergoing coronary surgery?

Historically, cardiologists and surgeons have considered obesity as a risk factor for mortality and morbidity during cardiac surgery. This factor has in fact been included in the Parsonnet score, one of the first risk stratification systems. This has led to an under-representation of obese patients with severe ischemic heart disease in the surgical population. A review of the recent literature seems to suggest that obesity is not any longer a risk factor for mortality and morbidity following coronary revascularization. Indeed, obesity is not included in the EuroSCORE, a more recent risk stratification system. Further evidence suggests that the use of off-pump coronary surgery in these patients is associated with a reduced in-hospital mortality and morbidity when compared with conventional coronary surgery with cardiopulmonary bypass and cardioplegic arrest.