Improvement of Ventricular Ejection Fraction after Bariatric Surgery in Obese Patients with Dilated Cardiomyopathy

Abstract

Morbid obesity has been considered a contraindication for cardiac transplantation in
some patients with Dilated cardiomyopathy (DCM). However, the positive effect of bariatric
surgery on this population, with improvement in Ventricular Ejection Fraction (VEF), could
even avoid the necessity of a cardiac transplant. Obesity produces cardiac dysfunction and
weight loss operations can partially revert it.
The impact of bariatric surgery among people with DCM has been studied in two
patients with morbid obesity. Both male patients suffered from DCM with a VEF less than
27%, and other co-morbidities. Their Body Mass Index (BMI) was 44 kg/m2
and 37 kg/m2
,
respectively. They underwent a sleeve gastrectomy and reached a BMI of 28 kg/m2
, 18 months
after the operation, with more than 10% improvement in their VEF. The second patient had a
gastric leak, due a stapler failure, and finally underwent an uneventful total gastrectomy after
unsuccessful endoscopic procedures.