Improvement in Pulmonary Hypertension Following Metabolic and Bariatric Surgery: a Brief Review and Meta-analysis

Abstract

We reviewed the available evidence on the outcome of metabolic and bariatric surgery (MBS) in patients with pulmonary hypertension (PH). Five studies examining 174 patients were included; the mean age was 54.5 ± 9.27 years; the mean BMI before surgery and at the end of follow-up were 47.2 ± 5.95 kg/m² and 37.4 ± 2.51 kg/m², respectively. Furthermore, the results showed a significant decrease in the right ventricle systolic pressure (RVSP) after MBS with a mean difference of 10.11% (CI 95%: 3.52, 16.70, I² = 85.37%, p = < 0.001), at 16.5 $\pm$ 3.8 month follow-up with a morbidity rate of 26% and 0 mortality. Thirty-day postoperative complications included respiratory failure, pulmonary embolism, pulmonary edema, and anastomotic leak. There appears to be a significant improvement in PH with a decrease in medication requirements after MBS.

Keywords: Adjustable gastric band; Bariatric surgery; Biliopancreatic diversion with duodenal switch; Metabolic surgery; Obesity surgery; One anastomosis gastric bypass; Pulmonary high blood pressure; Pulmonary hypertension; Pulmonary systolic pressure; Roux-en-Y gastric bypass; Sleeve gastrectomy.