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
