Question:
Will an ejection fraction of 25% disqualify me for lap roux surgery?

I have congestive heart failure. When I started my journey in march my last ejection fraction was 40%, it has now dropped to 25%. My cardiologist is not recommending surgery now. Will any surgeon still do surgery on me? I know it is risky but there is not much else I can do to help myself but lose weight. I cant exercise much because of my heart problem.    — bransonboy (posted on July 11, 2003)

July 11, 2003
Hi David, I don't know very much about congestive heart failure, but I know that most if not all surgeons will want clearance from you cardiologist and it sounds like he's not going to give it. I had to have clearance from a cardiologist and I've NEVER had heart problems (just used diet pills with ephedra in the past), but that is just my surgeon. It sounds like you are in a catch 22, need surgery to lose weight, but have to lose weight to survive surgery. I'm sorry, maybe you can find a surgeon to consult with your cardiologist and they can come up with a plan. Good Luck.
   — Ali M

July 11, 2003
Not a doctor, but I do type echo reports - and 25% is very low - I think it is way too risky, personally. Has something changed that caused your heart problem to get worse? Do they see it getting better? Your heart is just not healthy enough at this point, but again, this is just my opinion.
   — bethybb

July 11, 2003
I almost lost my Mom to CHF. What a nasty, brutal F###ing disease it is. I can't say how much I hate CHF. It would'nt be right to say in words how I truely feel aboout it. My heart goes out to you. I would like to mention one thing about my Mom, just in the wild chance that it "might" apply to you. Thanks to a blood clot that moved from her leg to her lungs she is now on O2 and her lungs are scared and not working fully. Anyway, back in late 1999 we thought the pulmonary hypertention was causing the CHF. After three months of watching her die before my eyes, and gaining 50 lbs of fluid I took her to the emergency room. To make a long story short, one of the things they did was to check her blood count. It was 14! No wonder she was dying. (Should have been around 38-40). It was anemia, not the pulmonary hypertention that was causing the congestive heart failure! All those months of blood tests for this and that, and xrays, and her nice, but imcompetant doctor never had the "smarts" to check her blood count. I'm really pissed off that her heart had to enlarge, and all the pain and mess of CHF because of an incompetant doctor. Now the damage is probally done and can't be fully reversed. Sorry to drag this out. I only mention this to in, just in case you may have anemia and IT is causing the CHF. If so, you may be able to get a transfusion, like Mom, and then the durectics worked to get the fluid off. She came to life right before my eyes after those four units of blood. She is still on O2 fulltime, (still has PH) but at least I still have my wonderful Mom with me. :) Please, check for anemia, if you have'nt already. Personally, I would think you would'nt survive wls surgery now. But who am I to say? I just remember how bad my Mom was and know "she could'nt have survived it" had she planned it. Check for anemia! Best of luck to you!
   — Danmark

July 11, 2003
David, I also agree with the previous posters. Your heart doesn't sound like it is strong enough to withstand WLS. My mom died last October mostly due to CHF, which she struggled with for five years; however, her rate was over 50% 30 days prior to her death. I'm not sure where you live in connection to a major city, but I would suggest that you locate a cardiologist at an university hospital that sub-specializes in CHF, at least for a second opinion and perhaps a new course of therapy that would give you the strength to go through WLS. I'm near Philadelphia, and would use the Jefferson Heart Institute associated with Jefferson University, as an example. Good luck, Dave
   — David F.

July 11, 2003
Don't give up. I know people who exist for years with EF's of 15%or so...very limited on their activity, etc. but the wt. loss will undoubtedly improve your overall condition as well as your heart function. Keep pursuing it.
   — Dana S.

July 20, 2003
dave, i to have a low EF (mine was 22% 1/03) and am researching WLS w/ both my GP and my Cardiologist. i have a consultation with a bariatric surgeon in my area (recomended by my cardiologist)on 7/30/03. my cardiologist isn't too sure about the surgery for me because of the high risk, but he is also aware that it is a catch 22 situation. everyone wants to explore every angle before proceeding. he did say that if i did undergo any type of proceedure it would probably be the "adjustable lap band" which is done laproscopically, is the least invasive and has you on the table for the least amount of time. you have to really sit down and talk with all of your doctors on this issue. keep me posted on how it goes for you and i will do the same when i get any feedback at the end of the month. take care. crystal
   — Crystal P.