I Was Planning to Do Liposuction but I Have an Incomplete Right Bundle Block, Should I Postpone Surgery?

Question

Hi I am young in mid 30s i was planning to have liposuction but found out i have incomplete right bundle block in ecg, doctor thinks its notihing but i see it contradicts with lidocain, my procedure was 120 minutes just local and needed advise. amount of fat predicted is 1.5 litres

Johan E. Brahme, MD · Answer

Any abnormality in the preoperative EKG should be evaluated by a cardiologist prior to proceeding with surgery. I also think that a board-certified anesthesiologist should be in charge of your intraoperative care during this procedure. Even if it's done under local anesthesia. This is, after all, elective surgery and should be done as safely as possible. Good luck

Darryl J. Blinski, MD · Answer

All answers stress the safety first idea. Get a cardio clearance is the best and only way to proceed.

Donald M. Brown, MD · Answer

Thank you for your question. A incomplete right bundle branch block is a defect in the heart's electrical conduction system. A recent article in the Archives of Internal Medicine  stated that the present of a bundle branch block does not significantly increase the likelihood of cardiac complications following noncardiac surgery.

	I would strongly suggest however, that you discuss this issue with both your cardiologist, your plastic surgeon and your anesthesiologist, before undergoing your surgery.  Best of luck.

Peter E. Johnson, MD · Answer

In order for cosmetic surgery to be an option, the procedures must be safe, and any medical condition should be evaluated through a process of medical clearance. Your primary care physician should know what your plans are, and have the opportunity to advise and prepare you for a safe liposuction outcome.
	Best of luck, peterejohnsonmd.com

Robert L. Kraft, MD, FACS · Answer

Any surgery, whether with anesthesia or not (and at 120 minutes, my expectation is that sedation, not straight local, would be involved) should be secondary to safety.   Medical clearance would be required from your cardiologist for any procedure, whether elective or medically necessary.  You should discuss this with your cardiologist and obtain his approval prior to considering liposuction.  I am sure that he will want to work you up in detail before making a decision. The procedure should be performed, if approved, in an accredited facility with a board certified anesthesiologist.

Peter A. Aldea, MD · Answer

The normal heart beat starts in a pacemaker in the top portion of the heart chamers (atria) is conducted to a hub called the AV node just above the bottom chambers(ventricles) which simultaneously pump blood to the white body (left ventricle) and the lungs (right ventricle). The electrical impulse leaving the AV Node leaves it through a short common channels which then splits into a right and left channel to each of the ventricles. A right bundle branch block means there is a slight delay in the contraction of the right ventricle. 

	From a surgeon's perspective all we want to know is it safe to operate. A cardiology ax action with a possible stress tests will give you the definitive answer. I do not thnk it will be a problem. 

	Good Luck

Ann F. Reilley, MD (retired) · Answer

My recommendations for safe surgery are as follows: First, obtain clearance for surgery by a cardiologist. Second, make sure that your surgery is performed in an accredidated facitilty by a Board Certified Plastic Surgeon. Third, have an MD in charge of your anaesthesia. And lastly, schedule your surgery on a day in which your cardiologist is in town, That way, in the unlikely event of a probelm, he/she is available and familiar with your history.

Ronald V. DeMars, MD (Retired) · Answer

First check with your cardiologist and make sure he clears you for the surgery. Then have him communicate with your plastic surgeon, and finally make sure a board certified anesthesiologist is in the room with you. That is your insurance should anything happen. If the surgery is done with the tumescent technique and a general anesthetic, the amount of lidocaine that will be in your blood is very low and the anesthesiologist will have a real time constant monitoring of your cardiac status.

Jay M. Pensler, MD - Account Suspended · Answer

Any cardiac problem should be discussed with your physician and in this case I would discuss this with your cardiologist.

Bruce K. Barach, MD (retired) · Answer

safety is paramount in procedures such as this; that said, i am reasonably certain an incomplete RBBB will not be a contraindication to having that relatively small lipo procedure done. clearance from your internist/cardiologist should be obtained and any suggestions/recommendations they make should be carried out. a more monitored setting than an office surgery with local by surgeon might not be a bad idea.

I Was Planning to Do Liposuction but I Have an Incomplete Right Bundle Block, Should I Postpone Surgery?

Answers (10)

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