"Gastric bypass surgery (also known as bariatric surgery) can be a safe operation for obese patients with heart disease, provided they receive a proper evaluation before the surgery, a new study shows.

In fact, gastric bypass surgery, which makes the stomach smaller so patients can eat less, and cuts out a long stretch of small intestine so fewer nutrients are absorbed, can lead to substantial improvements in heart disease risk factors, according to the study.

In their study, bariatric surgery was "about as safe" for patients with heart disease as it was for patients without heart disease, lead author Dr. Francisco Lopez-Jimenez, from the Mayo Clinic in Rochester, Minnesota, told Reuters Health. Moreover, for the heart disease patients, "the operation was associated with an impressive improvement in heart disease risk factors," he said.

The Mayo team compared the safety and effectiveness of gastric bypass in 52 obese heart patients and 507 obese patients without heart disease.

None of the patients died in the hospital, the report indicates. The rate of cardiac complications in the heart disease group was 5.8 percent, higher, but not significantly different than the 1.4 percent rate seen in the non-heart disease group.

After about 2.5 years of follow up, the heart disease group showed a significant drop in body mass index and blood pressure as well as levels of total cholesterol, "bad" LDL cholesterol, triglycerides and HbA1c, a measure of blood sugar, investigators report in the Mayo Clinic Proceedings.

As with any operation, for bariatric surgery to be successful, heart disease patients must receive an appropriate preoperative evaluation by an internist or cardiologist, Lopez-Jimenez emphasized. There may be some patients, he acknowledged, with severe heart disease that are not suitable candidates for bariatric or any other type of surgery.

SOURCE: Mayo Clinic Proceedings September" 2005.Reuters Health