Perioperative management of the bariatric surgery patient: focus on cardiac and anesthesia considerations

Obesity is a major public health problem in developed nations worldwide. Currently, the only treatment for severe obesity (BMI > or = 35 kg/m2 with comorbidity) that provides long-term weight loss is bariatric surgery. Restrictive, malabsorptive, and combination procedures have been developed. Each type of procedure has its merits and unique set of risks and complications. Weight loss after bariatric surgery is accompanied by predictable improvement or resolution of obesity-related comorbidities and improved quality of life and life expectancy. Candidates for bariatric surgery are often at high risk for complications because of obesity-related comorbidities. Therefore, careful patient selection for bariatric surgery, together with well-designed strategies for preventing and managing complications, are keys to success. Close monitoring for nutritional deficiencies and short- and long-term complications is required to completely assess outcomes of these procedures.