Mitral Valve Repair in Patients With Class I Obesity: A Propensity-Matched Analysis.
4 affiliations
- 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: https://twitter.com/SinaDaneshMD.
- 2Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.
- 3Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
- 4Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: [email protected].
Abstract
Background
Obesity may increase the technical complexity of robotic mitral valve (MV) repair, but comparative outcomes with sternotomy remain poorly defined.Objectives
This study aimed to compare perioperative and long-term outcomes of robotic vs sternotomy MV repair in patients with class I obesity.Methods
A total of 880 patients with class I obesity (body mass index 30-34.9 kg/m²) underwent MV repair at our clinic between 2008 and 2025. After excluding those with mitral stenosis, active endocarditis, prior sternotomy, or concomitant procedures, 429 patients remained. Propensity score matching (1:1) yielded 132 patients in each group who underwent either robotic or conventional sternotomy MV repair.Results
Median age was 59 years (IQR: 52-66), and 81% were male. Cardiopulmonary bypass and cross-clamp times were longer in the robotic group than in the sternotomy group (86 vs 65 minutes and 60 vs 48 minutes, respectively; P < 0.001). Robotic MV repair was associated with shorter hospitalization (3.5 vs 5 days; P < 0.001) and a lower postoperative transfusion rate (1.5% vs 10.6%; P = 0.002). There were no operative deaths in either group. No sternal wound infections occurred. Thirty-day readmission was numerically higher after robotic repair (12.8% vs 4.3%; P = 0.064). Ten-year survival was 92% (95% CI: 87% to 97%) with no significant difference between groups (P = 0.83).Conclusions
In patients with class I obesity, the robotic approach in comparison to sternotomy was associated with lower transfusion rates, shorter hospitalization, and comparable operative mortality and long-term survival relative to sternotomy. Although 30-day readmission was numerically higher among robotic patients, most events were minor and managed without intervention.
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BibTeX
@article{danesh2026mitral,
title = {{Mitral Valve Repair in Patients With Class I Obesity: A Propensity-Matched Analysis.}},
author = {Sina Danesh and Hartzell V Schaff and Aurora D Lee and Paul C Tang and Kimberly A Holst and Yazan Aljamal and Phillip G Rowse and Austin Todd and Richard C Daly and Joseph A Dearani and Juan A Crestanello and Arman Arghami},
journal = {JACC. Advances},
year = {2026},
month = oct,
doi = {10.1016/j.jacadv.2026.103310},
url = {https://europepmc.org/article/MED/42863354},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Mitral Valve Repair in Patients With Class I Obesity: A Propensity-Matched Analysis.
AU - Sina Danesh
AU - Hartzell V Schaff
AU - Aurora D Lee
AU - Paul C Tang
AU - Kimberly A Holst
AU - Yazan Aljamal
AU - Phillip G Rowse
AU - Austin Todd
AU - Richard C Daly
AU - Joseph A Dearani
AU - Juan A Crestanello
AU - Arman Arghami
PY - 2026
DA - 2026/10/12
JO - JACC. Advances
DO - 10.1016/j.jacadv.2026.103310
UR - https://europepmc.org/article/MED/42863354
AB - Background Obesity may increase the technical complexity of robotic mitral valve (MV) repair, but comparative outcomes with sternotomy remain poorly defined.Objectives This study aimed to compare perioperative and long-term outcomes of robotic vs sternotomy MV repair in patients with class I obesity.Methods A total of 880 patients with class I obesity (body mass index 30-34.9 kg/m²) underwent MV repair at our clinic between 2008 and 2025. After excluding those with mitral stenosis, active endocarditis, prior sternotomy, or concomitant procedures, 429 patients remained. Propensity score matching (1:1) yielded 132 patients in each group who underwent either robotic or conventional sternotomy MV repair.Results Median age was 59 years (IQR: 52-66), and 81% were male. Cardiopulmonary bypass and cross-clamp times were longer in the robotic group than in the sternotomy group (86 vs 65 minutes and 60 vs 48 minutes, respectively; P < 0.001). Robotic MV repair was associated with shorter hospitalization (3.5 vs 5 days; P < 0.001) and a lower postoperative transfusion rate (1.5% vs 10.6%; P = 0.002). There were no operative deaths in either group. No sternal wound infections occurred. Thirty-day readmission was numerically higher after robotic repair (12.8% vs 4.3%; P = 0.064). Ten-year survival was 92% (95% CI: 87% to 97%) with no significant difference between groups (P = 0.83).Conclusions In patients with class I obesity, the robotic approach in comparison to sternotomy was associated with lower transfusion rates, shorter hospitalization, and comparable operative mortality and long-term survival relative to sternotomy. Although 30-day readmission was numerically higher among robotic patients, most events were minor and managed without intervention.
SN - 2772-963X
ER -