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@article{Acharya:2016:10.1186/s13019-016-0467-2,
author = {Acharya, M and Harling, L and Moscarelli, M and Ashrafian, H and Athanasiou, T and Casula, R},
doi = {10.1186/s13019-016-0467-2},
journal = {Journal of Cardiothoracic Surgery},
title = {Influence of Body Mass Index on outcomes after minimal-access aortic valve replacement through a J-shaped partial upper sternotomy},
url = {http://dx.doi.org/10.1186/s13019-016-0467-2},
volume = {11},
year = {2016}
}

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TY  - JOUR
AB  - Objective: Minimal-access aortic valve replacement (MAAVR) may reduce post-operative blood loss and transfusion requirements, decrease post-operative pain, shorten length stay and enhance cosmesis. This may be particularly advantageous in overweight/obese patients, who are at increased risk of post-operative complications. Obese patients are however often denied MAAVR due to the perceived technical procedural difficulty. This retrospective analysis sought to determine the effect of BMI on post-operative outcomes in patients undergoing MAAVR.Methods: Ninety isolated elective MAAVR procedures performed between May 2006-October 2013 were recruited. Intra- and post-operative data were prospectively collected. Ordinary least squares univariate linear regression analysis was performed to determine the effect of BMI as a continuous variable on post-operative outcomes. One-way ANOVA and Chi-squared testing was used to assess differences in outcomes between patients with BMI <25 (n=36) and BMI ≥25 (n=54) as appropriate.Results: There was no peri-operative mortality, myocardial infarction or stroke. Univariate regression demonstrated longer cross-clamp times (p=0.0218) and a trend towards increased bypass times (p=0.0615) in patients with higher BMI. BMI ≥25 was associated with an increased incidence of hospital-acquired pneumonia (p=0.020) and new-onset atrial fibrillation (p=0.036) compared to BMI <25. However, raised BMI did not extend ICU (p=0.3310) or overall hospital stay (p=0.2614). Similar rates of sternal wound complications, inotrope requirements and renal dysfunction were observed in both normal- and overweight/obese-BMI groups. Furthermore, increasing BMI correlated with reduced mechanical ventilation time (p=0.039) and early post-operative blood loss (p=0.004).Conclusions: Our results demonstrate that within the range of this study, MAAVR is a safe, reproducible and effective procedure, affording equivalent clinical outcomes in both overweight/obese a
AU  - Acharya,M
AU  - Harling,L
AU  - Moscarelli,M
AU  - Ashrafian,H
AU  - Athanasiou,T
AU  - Casula,R
DO  - 10.1186/s13019-016-0467-2
PY  - 2016///
SN  - 1749-8090
TI  - Influence of Body Mass Index on outcomes after minimal-access aortic valve replacement through a J-shaped partial upper sternotomy
T2  - Journal of Cardiothoracic Surgery
UR  - http://dx.doi.org/10.1186/s13019-016-0467-2
UR  - http://hdl.handle.net/10044/1/31364
VL  - 11
ER  -

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