@article{ajmcr20261412,
author={{Suto, Yusuke and Sasaki, Akira and Umemura, Akira and Tanahashi, Yota and Kim, Hajime and Nitta, Hiroyuki},
title={Coronary Artery Bypass Surgery Performed after Laparoscopic Sleeve Gastrectomy in A Patient with Severe Obese of Severe Coronary Artery Stenosis},
journal={American Journal of Medical Case Reports},
volume={14},
number={1},
pages={5--9},
year={2026},
url={https://pubs.sciepub.com/ajmcr/14/1/2},
issn={2374-216X},
abstract={<i>Introduction</i>: Obesity is a significant risk factor for cardiovascular disease and causes obesity-related disorders (ORD), which are risks for surgery. Metabolic and bariatric surgery (MBS) improve ORDs, reducing preoperative risk. We report the case of a patient with severe obese of severe coronary artery stenosis who underwent laparoscopic sleeve gastrectomy (LSG) prior to coronary artery bypass grafting (CABG) to reduce the risks associated with latter surgery.<b> </b><i>C</i><i>ase presentation</i>: The 53-year-old (body mass index, BMI 43.2 kg/m<SUP>2</SUP>) male patient¡¯s comorbidities included obstructive sleep apnea, hypertension, dyslipidemia, and osteoarthritis of the knee, all on treatment. Sufficient weight loss was not achieved, so LSG was planned. Preoperatively, three-vessel coronary artery disease indicated the need for CABG. Six months post-LSG, the excess and total weight losses were 36.8% and 19.1%, respectively. He continued to lose weight successfully and underwent CABG 8 months post-LSG. The postoperative course was favorable; he was discharged on postoperative day 13. Sixteen months post-CABG, there are no complications and his progress remains stable.<b> </b><i>Clinical discussion</i>: Reports of two-stage cardiovascular surgery with preceding MBS are rare. However, MBS reduces visceral fat and improves several ORDs, thereby decreasing perioperative risks for CABG and potentially improving postoperative outcomes. While the ¡°obesity paradox¡± occurs in cardiovascular surgery, the benefits of prior MBS outweigh this effect.<b> </b><i>C</i><i>onclusion</i>: MBS preceded CABG in this case, reduced the associated risks, and is likely to improve postoperative outcomes. Moving forward, the waiting period post-MBS, and the severity of the cardiovascular disease, require further investigation.},
doi={10.12691/ajmcr-14-1-2}
publisher={Science and Education Publishing}
}