Bariatric surgery could be an option for obese heart failure patients

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Monday, October 31, 2022
Bariatric surgery could be an option for obese heart failure patients
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Bariatric surgery is known to reverse diabetes and other obesity-related conditions. Temple is studying its merits for treating heart failure.

NORTH PHILADELPHIA (WPVI) -- Obesity stresses a host of the body's organs, including the heart.

More and more, it's leading to heart failure, even in younger people.

Bariatric surgery is playing a growing role in easing that, even in patients once thought too risky.

"It actually started off with a cough that wouldn't go away," recalls 30-year-old Nikky Caraballo of North Philadelphia.

But what Nikky was initially told was bronchitis, was really heart failure.

Her heart was only pumping a fraction of the blood it should.

"I would have never thought, maybe you have heart failure. You're going to need a heart transplant," notes Nikky.

However, at 328 pounds, she wasn't a transplant candidate.

"The presence of heart failure combined with obesity is really something we're seeing a lot more of in the last decade," says Dr. Martin Keane, a Temple Health heart specialist.

Dr. Keane says each point of increase in Body Mass Index raises heart failure by 5% in men and 7% in women.

Because it's already well-known that major weight loss from bariatric surgery reverses diabetes, high blood pressure, and other conditions, Temple is now studying to see if it will relieve heart failure, too.

Previous studies on bariatric surgery and heart failure have been few, limited, and didn't include those on heart-assist devices.

"If you treat the obesity, you may be able to protect patients," says Dr. Keane.

"We've actually been able to offer the operation to people that have the extreme of heart failure where their heart is completely failed," says bariatric surgeon Dr. Rohit Soans.

"Putting patients with BMI over 40 on diet and exercise programs, especially with heart failure with the left ventricular assist device, has not really been successful. But surgery has," he adds.

"If you can reduce that load, that burden that heart has to pump out, then there's going to be huge improvements in the stability of the structure of the heart, the longevity of the heart," says Dr. Soans.

"And they're doing very well. and it actually improves their heart failure," says Dr. Keane of early observations from the study.

If it can even be done on patients like Nikky with LVADs - left ventricular assist devices - enabling them to qualify for heart transplants.

Knowing her life was on the line, she reformed her diet, losing 50 pounds before surgery.

And this admitted "chips, soda, and candy person" hasn't looked back - now hoping for a transplant.

"I was 328, and today I'm 153," Nikky says proudly.

In the middle of this, Nikky got COVID and lost her sense of taste, especially for proteins, making it hard to eat the foods she needed for strength and muscle mass.

"I just try to listen to music, and just calm myself down," says Nikky of managing the stress of changing her diet and hoping for a transplant.

"After the surgery, your relationship with food changes dramatically," she notes.

Her dream is going to Disney, and being able to fit on every ride.

The doctors expect good news soon from their study, and they predict a big jump in heart failure patients having surgery who were initially dismissed as being high risk.