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Thorac Cardiovasc Surg 2022; 70(02): 106-111
DOI: 10.1055/s-0041-1723973
Original Cardiovascular

Predictive Value of Body Mass Index in Minimally Invasive Mitral Valve Surgery

Jan-Philipp Minol
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
2   Department of Vascular and Endovascular Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Vanessa Dimitrova
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Georgi Petrov
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Robert Langner 
3   Institute of Systems Neuroscience, and Statistical Advisory Office, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Udo Boeken 
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Artur Lichtenberg
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
,
Payam Akhyari 
1   Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
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Abstract

Background With this study we aimed to analyze if the separate consideration of body mass index (BMI) could provide any superior predictive values compared with the established risk scores in isolated minimally invasive mitral valve surgery (MIMVS). This might facilitate future therapeutic decision-making, e.g., regarding the question surgery versus transcatheter mitral valve repair (TMVr).

Methods We assessed the relevance of BMI in non-underweight patients who underwent isolated MIMVS. The risk predictive potential of BMI for mortality and several postoperative adverse events was assessed in 429 consecutive patients. This predictive potential was compared with that of European System for Cardiac Outcome Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons score (STS score) using a comparative receiver operating characteristic curve analysis.

Results BMI was a significant numeric predictor of wound healing disorders (p = 0.001) and proved to be significantly superior in case of this postoperative adverse event compared with the EuroSCORE II (p = 0.040) and STS score (p = 0.015). Except for this, the predictive potential of BMI was significantly inferior compared with that of the EuroSCORE II and STS score for several end points, including 30-day (p = 0.029 and p = 0.006) and 1-year (p = 0.012 and p = 0.001) mortality.

Conclusion Therefore, we suggest that, in the course of decision-making regarding the right treatment modality for non-underweight patients with isolated mitral valve regurgitation, the sole factor of BMI should not be given a predominant weight.

Keywords

minimally invasive approach - mitral valve surgery - obesity - body mass index


Publication History

Received: 30 September 2020

Accepted: 07 January 2021

Article published online:
12 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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