Minimally Invasive Mitral Valve Repair Using Transcatheter Chordal Attachments

Das, Chandan; Al Awwa, Ghayth; Mills, Emmanuel L.; Lantz, Gurion

doi:10.1016/j.iccl.2023.12.006

Cited by 1 publication

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As cardiac surgery will be confronted with more obese patients in the foreseeable future, strategies to reduce WHDs are urgently needed. Minimally invasive techniques that do not require conventional sternotomy seem to be the most promising options in cardiac surgery in obese patients: In mitral valve surgery, lateral mini thoracotomy becomes more and more common[ 28 ], and catheter techniques [ 29 ] or robotic surgery are emerging [ 30 ]. In aortic valve disease, the ongoing discussion about the indications between transcatheter aortic valve implantations and conventional approaches via sternotomy [ 31 ] should be[ 32 ] extended[ 33 ] and obese[ 34 ] patients should be treated.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Obesity in Cardiac Surgery: A 14 years’ Follow-Up of 14.754 Patients

Beckmann,

Poehlmann,

Mayr

et al. 2024

Journal of Obesity

View full text Add to dashboard Cite

Aims. The prevalence of obesity is rapidly increasing during the past decades. While previous research has focused on the early outcome after cardiac surgery or specific complications, the current study covers the whole burden of obesity in the field of cardiac surgery over short term and long term. Endpoints of the study were all-cause mortality, perioperative outcome, and wound-healing disorders (WHDs). Methods. 14.754 consecutive patients who underwent cardiac surgery over a 14 years’ time period were analyzed. BMI classifications were used according to the WHO definition. Results. Mean survival was 11.95 years ± 0.1; CI 95% [12.04–12.14]. After adjustment for clinical baseline characteristics, obesity classes’ I–III (obesity) did not affect 30-day mortality or all-cause mortality during the whole observational period. After adjustment for known risk factors, the risk for WHDs doubled at least in obesity patients as follows: obesity I (OR = 2.06; CI 95% [1.7–2.5]; p<0.0001), obesity II (OR = 2.5; CI 95% [1.83–3.41]; p<0.0001), and obesity III (OR = 4.12; CI 95% [2.52–6.74]; p<0.0001). The same applies to the risk for sternal reconstruction that is substantially elevated in obesity I (OR = 2.23; CI 95% [1.75–2.83]; p<0.0001), obesity II (OR = 2.81; CI 95% [1.91–4.13]; p<0.0001), and obesity III (OR = 2.31; CI 95% [1.08–4.97]; p=0.03). No significant correlation could be found between obesity and major adverse events in the perioperative course like renal failure, ventilation >24 h, re-exploration, or cerebrovascular events. Conclusions. Cardiac surgery is safe in obesity as short- and long-term mortality are not increased, and major adverse events during the perioperative course are similar to control patients. The burden of obesity lies in substantially increased rates of wound-healing disorders and sternal reconstructions.

show abstract