Obesidade mÓrbida e cirurgia cardíaca

Objective: Obesity is cousidered 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, Design: 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/m 2 ) 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 day 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.