Dr. Radha Gopalan, a cardiologist at Phoenix-based Banner Health, was disturbed by a growing trend in his practice in which young, obese patients were dying from heart failure.
Their deaths were the result of an awful predicament. These patients had heart failure so advanced they required a heart transplant, but they were ineligible because their body mass index was higher than 35, the cutoff for the procedure to be performed safely at most transplant centers.
At the same time, weight loss through diet and exercise is usually impossible for these patients and most bariatric surgeons refuse to perform surgery on heart failure patients because of the high risk of complications.
As a result, these patients “have no way of extending their lives,” Gopalan said, and because the problem is likely to only get worse given the predicted continued rise of obesity in the U.S., he was motivated to look for a solution.
So soon after joining Banner in mid-2017, Gopalan approached his colleague Dr. Robin Blackstone, who leads the Banner-University Medicine Obesity and Bariatric Surgery Center, with the idea of working together to help these patients become eligible for heart transplants by performing bariatric surgery to reduce their BMI. She agreed, albeit warily. Because the procedures aren’t done routinely or supported by research, they’re risky.
“There was caution on my part,” Blackstone said. “It was really important to me to communicate with the patient, so they understand where we are in our state of knowledge about this.”