Is obesity associated with poorer outcomes in patients undergoing minimally invasive mitral valve surgery?

Aljanadi, Firas; Toolan, Caroline; Theologou, Thomas; Shaw, Matthew; Palmér, Kenneth; Modi, Paul

doi:10.1093/ejcts/ezaa274

Cited by 9 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Five-year outcomes were reported with rates of mortality, stroke, AKI, DSWI and reoperation for bleeding provided. 40 Boukhris et al retrospectively analysed the outcomes of 412 TAVR patients with underweight (<20 kg/m 2 ), normal weight (≥20 to <25 kg/m 2 ), overweight (≥25 to <30 kg/m 2 ) and obesity (≥30 kg/m 2 ). Postoperatively, patients were followed for 1 year.…”

Section: Background Informationmentioning

confidence: 99%

See 1 more Smart Citation

Heart valve surgery and the obesity paradox: A systematic review

et al. 2021

View full text Add to dashboard Cite

Obesity has been associated with increased incidence of comorbidities and shorter life expectancy, and it has generally been assumed that patients with obesity should have inferior outcomes after surgery. Previous literature has often demonstrated equivalent or even improved rates of mortality after cardiac surgery when compared to their lower-weight counterparts, coined the obesity paradox. Herein, we aim to review the literature investigating the impact of obesity on surgical valve interventions. PubMed and Embase were systematically searched for articles published from

show abstract

Section: Background Informationmentioning

confidence: 99%

“…32 The studies conducted by Aljanadi, Bruno, De Marzo, Forgie, Ho, Keller, Nazir, Rapetto, Smith and van der Boon did not find significant differences in mortality rates between their groups. 11,15,16,25,40,43,46,48,49,52…”

Section: Postoperative Mortalitymentioning

confidence: 99%

Heart valve surgery and the obesity paradox: A systematic review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…9 Aljanadi et al found that five-year survival between obese and non-obese patients undergoing minimally invasive mitral valve surgery was similar (95.8% vs 95.5%, p=0.83). 10 In consideration of the patient with obesity, Santana et al demonstrated minimally invasive approaches to be superior to full sternotomy with fewer postoperative complications (23.5% vs 51.0%, p=0.034) and lower in-hospital mortality (0% vs 8.3%, p=0.04). 4 However, to date, these observations have not been scrutinized between obesity classes, raising question of the broad application of these findings across the continuum of higher BMIs.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Amongst Obesity Class I, II, and III Patients Undergoing Minimally Invasive Aortic Valve Replacement

Sabatino

Yang

Soliman

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Minimally invasive heart valve surgery has previously been shown to be safe and feasible in obese patients. Within this population, we investigated the effect of obesity class on the patient outcomes of minimally invasive aortic valve replacement (mini-AVR). Methods: A single center retrospective cohort study of consecutive patients with obese body mass indices (BMIs) who underwent mini-AVR between 2012 and 2018. Patients were stratified into 3 groups according to Centers for Disease Control and Prevention adult obesity classifications: Class I (BMI 30.0 to < 35.0), Class II (BMI 35.0 to < 40.0), and Class III (BMI ≥ 40.0). The primary outcomes were postoperative length of stay (LOS), 30-day mortality within, and cost. Results: Amongst 182 obese patients who underwent mini-AVR, LOS (Class I 4 [3-6] vs. Class II 4 [3-6] vs. Class III 5 [4-6] days; p=0.098) and costs (Class I $24,487 [$20,199-$27.480] vs. Class II $22,921 [$20,433-$27,740] vs. Class III $23,886 [$20,063-$33,800] USD; p=0.860) did not differ between obesity class cohorts. Postoperative 30-day mortality (Class I 2.83% [n=2] vs. Class II 0% [n=0] vs. Class III 0% [n=0]; p=0.763) was limited by an insufficient sample size relative to a low event rate but did not differ between patient cohorts. Conclusions: Mini-AVR is safe and feasible to perform for obese patients regardless of their obesity class. Patients with obesity should be afforded the option of minimally invasive aortic valve surgery regardless of their obesity class.

show abstract

“…Median-term results reported on obese minimally invasive mitral surgery patients showed no difference in survival to nonobese patients. 15,25 Robotic surgery has no shortcomings in allowing adequate mitral repair and avoidance of adverse events in the early period which can result in better long-term survival in obese patients with more co-existing comorbidities. These high-risk patients are not selected for robotic surgery in some institutions and may not be selected in the early periods of the learning curve.…”

Section: Statisticsmentioning

confidence: 99%

Robotic mitral valve operations can be safely performed in obese patients

Şenay

Çaçur

Baştopçu

et al. 2021

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Introduction Robotic cardiac surgery offers mitigated risks for obese patients requiring mitral valve surgery. We aimed to study the safety of robotic mitral surgery in the obese patient population by analyzing the outcomes of mitral surgery patients in our center for robotic cardiac surgery. Method This study retrospectively included 123 consecutive patients who underwent robotic mitral valve operations in a single center for robotic cardiac surgery. Patients with body mass index (BMI) ≥ 30 were compared against patients with BMI < 30 for demographic and operative parameters as well as postoperative outcomes. Results Mean BMI was 33.9 ± 2.8 in the obesity group (n = 87) and 25.4 ± 2.7 in the no‐obesity group (n = 36). Female gender (80.6% vs. 52.9%, p = .004), diabetes (25.0% vs. 10.3%, p = .036), and hypertension (48.6% vs. 26.4%, p = .018) were more common in patients with obesity. The obesity group was operated with similar cardiopulmonary bypass and total operative times with the no‐obesity group. Postoperative drainage and blood transfusion requirements were similar between the groups. Mechanical ventilation times (6.1 ± 2.2 vs. 8.0 ± 4.4 h, p = .003) and intensive care unit stay (20.4 ± 1.6 vs. 29.4 ± 3.7, p = .027) were shorter in the obesity group. Other postoperative outcomes of infection, atrial fibrillation, hospital stay duration, and readmission rates were similar between the groups. Conclusion Robotic mitral surgery is safe to perform in obese patients. Obesity should not be a contraindication for robotic mitral surgery as obese patients have outcomes similar to nonobese patients despite increased challenges and risk‐factors.

show abstract

Is obesity associated with poorer outcomes in patients undergoing minimally invasive mitral valve surgery?

Cited by 9 publications

References 18 publications

Heart valve surgery and the obesity paradox: A systematic review

Heart valve surgery and the obesity paradox: A systematic review

Outcomes Amongst Obesity Class I, II, and III Patients Undergoing Minimally Invasive Aortic Valve Replacement

Robotic mitral valve operations can be safely performed in obese patients

Contact Info

Product

Resources

About