Preoperative evaluation for bariatric surgery using transesophageal dobutamine stress echocardiography.
BACKGROUND
Bariatric surgery is an effective option for weight control in morbid obesity. The goal of this study was to assess cardiac risk prior to bariatric surgery using transesophageal-dobutamine stress echocardiography (TE-DSE).


METHODS
7 morbidly obese patients (mean BMI 67.7 +/- 15.6) were prospectively evaluated by TE-DSE prior to bariatric surgery.


RESULTS
All patients underwent TE-DSE without complications. 6 of 7 patients had no evidence of ischemia on TE-DSE. One patient had abnormal TE-DSE showing inferior ischemia and was treated with beta-blockers and nitrates prior to surgery and had no complications. All patients underwent surgery without cardiac complications. 1 patient died at 18 days of sepsis. Over a mean follow-up period of 11 months, the 6 surviving patients have not experienced any cardiac events. Their average weight loss is 58.2 kg.


CONCLUSIONS
TE-DSE is a valuable noninvasive technique for predicting cardiac risk in morbidly obese patients undergoing bariatric surgery.
University of Louisville, Division of Cardiology, Louisville, KY, USA. g0bhat01@louisville.edu
Geetha
G
Bhat
Kathy
K
Daley
Margaret
M
Dugan
Gerald
G
Larson
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D025401:Echocardiography, Stress; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care; D016277:Ventricular Function, Left