BODY MASS INDEX IMPACT ON MINIMALLY INVASIVE MITRAL VALVE SURGERY: REPORT FROM A MULTICENTER REGISTRY

Background and Aim: underweight and obese patients represent an unquestionable challenge for cardiac surgeons. To date only few reports analyze the relationship between patient BMI and minimally invasive mitral valve (MIMV) surgery outcomes. Aim of this study is to evaluate the effect of BMI on patients undergoing MIMV surgery Methods: data of consecutive patients undergoing MIMV surgery at 7 high-volume cardiac surgery centers experienced in MIMV surgery were collected. Both MIMV repair or replacement were considered as well as combined procedure. 30-day mortality was defined as the primary end-point. To make a meaningful comparison a propensity score matching was performed Results: 1692 patients were enrolled. 1463 (86%) were normal weight, 153 (9%) patients were obese and 76 (5%) patients were underweight. Before matching, both underweight and obese patients showed a higher risk profile at surgery when compared to normal weight patients (higher rate of CKD, COPD, previous cardiac surgery and lower EF). Underweight patients showed a higher rate of re-intubation and blood transfusion, while obese patients showed a higher ICU and in-hospital LOS and a higher 30-day mortality. After matching no significant differences were reported in terms of 30-day mortality and post-procedural complications. Conclusion: MIMV surgery seems to be a safe and feasible approach in underweight and obese patients too. A high expertise in MIMV surgery and optimal pre-operative planning are mandatory to achieve these results