Bariatric surgery, or metabolic and weight loss surgery, has become a widely accepted and effective therapeutic modality for individuals with severe obesity and its associated comorbidities. Obesity is a significant risk factor for cardiovascular disease, the leading cause of morbidity and mortality worldwide.
The indications for bariatric surgery are typically based on body mass index (BMI). Typically, a BMI of >40 or a BMI of >35 with the presence of one or more obesity-related comorbidities such as type 2 diabetes, hypertension, and obstructive sleep apnea meet the criteria for surgical intervention. Bariatric surgery procedures induce significant weight loss and improve metabolic parameters, ameliorating these and other comorbid conditions.
The primary objective of bariatric surgery is to restrict food intake by reducing stomach capacity, thereby promoting weight loss. Several types of bariatric surgery are performed in current clinical practice.
The Roux-en-Y gastric bypass (RYGB) is a restrictive and malabsorptive procedure. A small gastric pouch is created by transecting the proximal stomach and rerouting the proximal small intestine to the new pouch. The distal small intestine is connected to the Roux limb, forming the Y-shaped configuration. The procedure decreases stomach capacity and reduces calorie and nutrient absorption.
A sleeve gastrectomy is a restrictive procedure removing a significant portion of the stomach, leaving a narrow, sleeve-shaped stomach.
The adjustable silicone gastric banding (ASGB) procedure places an inflatable band near the upper stomach to form a small gastric pouch. The band is connected to a subcutaneous access port. Inflating or deflating the band via the access port modifies the pouch size.
Biliopancreatic diversion with duodenal switch (BPD-DS) is a comprehensive surgical procedure combining elements of restriction and malabsorption. A significant portion of the stomach is resected, and the proximal small intestine is rerouted to a new connection, creating a common channel.
Intragastric balloon (IGB) placement is a nonsurgical, restrictive procedure. A deflated silicone balloon is inserted into the stomach via the oral cavity. Once the inserted balloon is inflated with saline or air, it can help reduce feelings of hunger and promote weight loss.
All surgical procedures inherently involve perioperative, short-term, and long-term risks and complications, especially concerning cardiovascular outcomes. This activity examines the existing knowledge regarding the influence of bariatric surgery on the cardiovascular system.
Copyright © 2024, StatPearls Publishing LLC.