Bariatric Surgery for Patients Living with Obesity and Left Ventricular Dysfunction: Evaluating Perioperative Safety...

Obesity and heart failure with left ventricular ejection disfunction (LVED) are intertwined and rising worldwide. Weight loss through bariatric surgery improves cardiac function. We aimed to assess the incidence of perioperative complications in patients with severe obesity and LVED who had bariatric surgery, and the long-term effectiveness of surgery.

In a single-center observational retrospective study, we compared patients with body mass index ≥35 kg/m² and LVED (defined as left ventricular ejection fraction (LVEF) < 50%) having bariatric surgery, to propensity-matched controls without LVED. The primary outcome was the incidence of complications during the initial 30 postoperative days. We also evaluated length of hospital stay, and weight loss, LVEF, and functional capacity one year after surgery.

Overall, 79 patients were included, 38 with LVED (LVEF, 35 ± 9%) and 41 controls (LVEF, 59 ± 5%). There were not differences in baseline characteristics. The overall incidence of postoperative complications was similar. Patients with LVED had higher rate of minor complications (Clavien-Dindo grades 1 and 2, p < 0.05), which did not affect hospital length of stay (4 ± 5 vs. 3 ± 1 days) (p). After one year, bariatric surgery was effective with overall total weight loss of 34 ± 20%. Patients with LVED showed a 6 ± 10% increase in LVEF, and improvement in functional capacity.

Patients with LVED have higher incidence of minor complications after bariatric surgery with no impact on length of hospitalization. Bariatric surgery is associated with a significant improvement in both LVEF and functional capacity.