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

he obesity epidemic and the limited efficacy of dietary therapy to treat obesity have resulted in a surge in the volume of bariatric surgery. Obesity-related comorbidities are numerous and present a variety of preoperative, intraoperative, and postoperative challenges in obese patients undergoing any type of surgery and in those specifically referred for bariatric surgery. At the same time, the outcomes of bariatric surgery are increasingly good in terms of excess weight loss, reductions in comorbidities, increased life span, and overall medical costs. Using a case for illustrative purposes, this article examines clinical considerations in the management of obese surgical patients as well as patients undergoing gastric bypass surgery. ■ OVERVIEW OF BARIATRIC SURGERIES