End-stage cardiac failure in a morbidly obese patient treated by biliopancreatic diversion and cardiac transplantation.
A 57-year-old 132-kg female (BMI 48.6) with end-stage cardiac failure is presented. Because of a progressive cardiomyopathy, the patient required a heart transplant. However, before receiving the transplant, major weight loss was deemed to be mandatory. Supervised dieting had manifestly failed, and thus a highly effective weight-reducing operation, biliopancreatic diversion, was performed. This resulted in a weight loss of 50.4 kg in 9 months. She then underwent successful cardiac transplantation, and progressed well for several months. She then developed severe psychiatric depression, withheld her medications and developed a lethal acute rejection phenomenon.
Taylor
Thomas V
TV
Baylor College of Medicine, Houston, TX, USA. thomas_taylor@stjoe.sch.org
Bozkurt
B
B
Shayani
Payam
P
Lafuente
J
J
Noon
G
G
D015904:Biliopancreatic Diversion; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*