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