title: Cardiac surgery and morbid obesity.
abstract: OBJECTIVE
  Obesity is considered a risk factor for the occurrence of complications after cardiac surgery. The objective of this study was to analyze mortality and morbidity in patients with morbid obesity following heart surgery.
  
  
  METHODS
  Retrospective study in a tertiary care setting.
  
  
  METHODS
  Out of 1815 adult patients undergoing cardiac surgery, 50 consecutive patients (3%) with morbid obesity (defined by a body mass index (BMI) > 35 kg/m2) operated on between 7/98 and 3/01 were studied. Mean age was 61.9 +/- 10.4 years, mean BMI was 38.0 +/- 2.7 kg/m2 and mean Parsonnet score was 14.3. Thirty patients had CABG, 14 underwent valve surgery and 6 had combined valve and CABG.
  
  
  RESULTS
  Three patients died in the first 30 days (hospital mortality = 6%). Four patients had myocardial infarction (8%), 4 patients had stroke (8%) and 13 required blood transfusion (29%). There were no deep sternal wound infections or reoperations but 9 patients (15%) presented superficial wound infections. Mean ICU and hospital stay were 2.2 +/- 2.2 and 6.8 +/- 4.1 days respectively. With a mean follow up of 13.9 +/- 8.9 months, 4 patients died; 38 (93%) out of the 41 patients reviewed are in NYHA class I or II and 27 (65%) have unrestricted physical activity.
  
  
  CONCLUSIONS
  Cardiac surgery in patients with morbid obesity carries a higher morbidity and mortality risk. Short- and medium-term results were satisfactory with improvement in quality of life in two-thirds of the patients.
authors.affiliation: Departamento de Circulação, Serviço de Cirurgia Cardiotorácica, Hospital da Cruz Vermelha, Lisboa. uvamiguel@hotmail.com
authors.forename: Miguel Sousa
authors.initials: MS
authors.lastname: Uva
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rodrigues
authors.forename: Nuno
authors.initials: N
authors.lastname: Monteiro
authors.forename: Albino
authors.initials: A
authors.lastname: Manuel Pedro
authors.forename: Rui
authors.initials: R
authors.lastname: Caria
authors.forename: Armindo
authors.initials: A
authors.lastname: Mesquita
authors.forename: Judith
authors.initials: J
authors.lastname: Fernandes
authors.forename: João
authors.initials: J
authors.lastname: Pinho
authors.forename: José
authors.initials: J
authors.lastname: Bau
authors.forename: Pedro
authors.initials: P
authors.lastname: Magalhães
mesh_terms: D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome