Obesity and coronary surgery: new concepts for an old problem

Since its introduction into clinical practice, coronary artery bypass graft (CABG) has become the most popular cardiac surgery procedure and, despite the challenge of cardiology interventional revascularization, an average of 1000 procedures per 1 million inhabitants are performed in Western countries annually. In the last decade, due to significant improvements in pre- and postoperative management, the indication for CABG has been extended to include patients with relevant comorbidity and severe preoperative risk score assessment. Obesity has become one of the most frequent risk factors for potential candidates for CABG, especially in selected geographical areas. Relationships between obesity and CABG have been investigated by several authors, with contrasting results. This is probably due to the inhomogeneous criteria for definition of obesity and different end points used in different studies. In this article we present a brief summary of recent developments, with a particular focus on future applications.