title: Metabolic and cardiovascular improvements after biliopancreatic diversion in a severely obese patient.
abstract: BACKGROUND
  Severe obesity is associated with important morbidity and increased mortality. The successes of lifestyle modifications and drug therapy have been partial and mostly unsustained in reducing obesity and its comorbidities. Bariatric surgery, particularly biliopancreatic diversion with duodenal switch reduces efficiently excess body weight and improves metabolic and cardiovascular functions.
  
  
  METHODS
  A 56-year-old man with severe clinical obesity underwent a biliopancreatic diversion with a duodenal switch after unsuccessful treatment with weight loss pharmacotherapy. He had diabetes, hypertension and sleep apnea syndrome and was on three medications for hypertension and two hypoglycemic agents in addition to > 200 insulin units daily. Eleven months after the surgery, he had lost 40% of his body weight. The lipid profile showed great improvement and the hypertension and diabetes were more easily controlled with no more insulin needed. The pseudonormalized pattern of left ventricular diastolic function improved and ventricular walls showed decreased thickness.
  
  
  CONCLUSIONS
  Biliopancreatic diversion may bring metabolic and cardiovascular benefits in severely obese patients from a cardiovascular perspective.
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie, Hôpital Laval, 2725 Chemin Ste-Foy, Quebec, Qc, G1V 4G5, Canada. woodsphilippe@hotmail.com
authors.forename: Philippe
authors.initials: P
authors.lastname: Woods
authors.forename: Carmen
authors.initials: C
authors.lastname: Paquette
authors.forename: Julie
authors.initials: J
authors.lastname: Martin
authors.forename: Jean-Gaston
authors.initials: JG
authors.lastname: Dumesnil
authors.forename: Picard
authors.initials: P
authors.lastname: Marceau
authors.forename: Simon
authors.initials: S
authors.lastname: Marceau
authors.forename: Simon
authors.initials: S
authors.lastname: Biron
authors.forename: Frédéric
authors.initials: F
authors.lastname: Hould
authors.forename: Odette
authors.initials: O
authors.lastname: Lescelleur
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lebel
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier