The document discusses various techniques for bariatric surgery and their results. It also discusses how bariatric surgery prevents cardiovascular events through mechanisms like weight loss, reduced visceral fat and sympathetic overactivity, improved metabolism, reduced endothelial dysfunction, reduced organ damage, and improved cardiovascular performance. Several studies are summarized that examine the impact of bariatric surgery on cardiovascular disease and mortality risk, myocardial infarction risk, and stroke risk compared to no surgery. Other topics discussed include insulin resistance and cardiovascular risk markers after bariatric surgery, and how bariatric surgery in adolescents may decrease adult cardiovascular mortality. The document considers why bariatric surgery should be considered as a therapeutic option for patients.

1. Cirurgia Bariátrica
Diferentes Técnicas e Seus Resultados

5. Adjustable Gastric Band

6. Weight Loss?

8. How Bariatric Surgery
Prevents CV Events?
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

9. Weight Loss
Visceral fat
Sympathetic overactivity
Long-term morbidity
DMT2
Metabolic Syndrome
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

10. Metabolism
HDL cholesterol
Triglycerides and LDL - cholesterol
Insuline sensitivity
Apoprotein ApoA4
Adiponectin
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

11. Improved of Endothelial Dysfunction
Oxydized LDL
VEGF-A
ICAM-1
Endotelin-1
E-selectin
ESR, WBC, HsCRP
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

12. Organ Damage
NAFLD and liver steatosis
liver enzymes
kidney function
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

13. Cardiovascular Performance
Obstructive Sleep Apnea Syndrome
Left Ventricular Hypertrophy
Hypertension
Improvement of markers of early atherosclerosis
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

14. Bariatric surgery and its impact on cardiovascular disease and
mortality: A systematic review and meta-analysis
Chun Shing Kwok, Ashish Pradhan , Muhammad A. Khan , Simon G. Anderson , Bernard D. Keavney , Phyo Kyaw
Myint , Mamas A. Mamas , Yoon K. Loke
International Journal of Cardiology 173 (2014) 20–28

15. International Journal of Cardiology 173 (2014) 20–28
Meta-analyses of mortality risk after bariatric surgery as
compared to no surgery.

16. International Journal of Cardiology 173 (2014) 20–28
Meta-analysis of risk of myocardial infarction after
bariatric surgery compared to no surgery.

17. International Journal of Cardiology 173 (2014) 20–28
Meta-analysis of stroke risk after bariatric
surgery as compared to no surgery

18. Insulin Resistance and Cardiovascular Risk Marker Evaluation
in Morbid Obesity 12 Months After Bariatric Surgery Compared
to Weight-Matched Controls
OBES SURG (2014) 24:349–358

24. Bariatric and Metabolic Surgery in Adolescents: a
Path to Decrease Adult Cardiovascular Mortality
Curr Atheroscler Rep (2015) 17: 53
 Bogalusa study : 9167 children/10 years follow-up (mean age 10
years) - 87 % of those whose BMI was above the 95th percentile in
childhood were obese as adults (mean age 28 years)
 Boyd Orr Cohort : 4999 children - 65years followup: clear
relationship between BMI and mortality
 LVH can occur early in life and BMI and total adipose tissue mass
predict abnormal ventricular geometry in children and adolescents
 Adolescents with dyslipidemia and overweight or obesity have had
increases in adult carotid intimal medial thickness
 Younger age of onset of T2DM (BMI) could be expected to lead to
earlier CV complications.
 Obesity is associated with chronic inflammation, and this has also
been shown in children

25. Why should we think in Bariatric
Surgery as an option for our patients?
Is Bariatric Surgery the solution?
Should it be included as a therapeutic
option?