Abstract 9881: Safety of Bariatric Surgery in Obese Patients with Hypertrophic Cardiomyopathy

Abstract

Introduction: Obesity is an independent risk factor for heart failure in patients with hypertrophic cardiomyopathy (HCM). Bariatric surgery is associated with improved cardiac function in obese patients with heart failure, but the safety of this procedure has not been evaluated in HCM patients. In this study, we examined national trends and early outcomes in bariatric surgery for patients with HCM. Methods: Using the weighted discharge data from the National Inpatient Sample, we identified adult patients with HCM who underwent elective bariatric surgery for obesity between 2011 and 2017. Patients with a history of bariatric surgery or having malignant neoplasms in the esophagus, stomach, small intestine, or pancreas were excluded. Results: A total of 443 obese patients with HCM were identified, and 41.8% (n=185) had obstructive HCM. The annual number of patients increased from 18 in 2011 to 130 in 2017, and nearly half of the patients (48%) had bariatric surgery in 2016 and 2017. Overall, the median (IQR) age was 50 (43-57) years, and 85 (19%) patients were 60 years or older. Approximately 20% (n=90) of the patients had heart failure at the time of operation. Atrial fibrillation was present in 83 (19%) patients, and 22% (n=95) of the cohort had a pacemaker or automatic cardiac defibrillator implanted prior to the operation. Laparoscopic sleeve gastrectomy (72%, n=318) and laparoscopic Roux-en-Y gastric bypass (25%, n=110) were the most commonly performed bariatric procedures. Overall, patients stayed in hospital for a median (IQR) of 2 (1-2) days. During the hospital stay, 1% (n=5) of the patients had acute worsening of chronic heart failure, but there were no deaths, cardiac arrests, or cerebrovascular accidents post procedure. Conclusions: Bariatric surgery in patients with HCM is performed more frequently in recent years and is safe and associated with few perioperative complications. Given the impact of obesity on long-term survival, clinicians should strongly consider bariatric surgery for HCM patients who do not respond to conservative weight loss measures.