Right ventricular volume assessment. An alternative perspective.

704 Communications to the Editor shown that patients with OSA often have cranio-facial abnormalities that play a role in the development of their disease. Very obese patients often have few of these abnormalities, but it is highly recommended that patients be reassessed when weight loss has been sufficient to eliminate residual apneas related to upper airway anatomic abnormalities that persist despite weight loss. Considering the new weight-reduction programs now available with regular long-term follow-up by multi-specialists, one may have to decide which program (surgical or medico-behavioral) will be able to provide the most appropriate and significant weight reduction with maintenance ofweight loss and with the least amount of morbidity risk for each individual case. However, nasal CPAP (or tracheostomy), with or without supplemental oxygen, will initially be required if any of these weight loss-related approaches is selected for immediate control of OSA and related clinical symptoms.