Isolated Robotic Mitral Valve Replacement Across Body Mass Index Categories: Early Perioperative Outcomes
- 1Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul 34303, Türkiye
- 2Department of Cardiovascular Surgery, TekirdagNamık Kemal University, Tekirdag 59030, Türkiye
Abstract
Background: Obesity may pose additional technical and perioperative challenges in robotic mitral valve surgery. This study evaluated early perioperative outcomes of isolated robotic mitral valve replacement (MVR) across BMI categories. Methods: We retrospectively analyzed 146 patients who underwent isolated robotic MVR at a single center, categorized into BMI categories of <25 kg/m2 (n = 60), 25.0–29.9 kg/m2 (n = 38), or ≥30 kg/m2 (n = 48). Preoperative characteristics, operative variables, and early postoperative outcomes were compared among groups. The study was exploratory. Four clinically selected outcomes, cardiopulmonary bypass time, ventilation duration, hospital length of stay, and postoperative left ventricular ejection fraction, were evaluated using adjusted median quantile regression with bootstrap 95% confidence intervals, and multiplicity across postoperative outcomes was addressed using the Benjamini–Hochberg false discovery rate. Results: Patients with BMI ≥ 30 kg/m2 were older and had a higher prevalence of diabetes and higher EuroSCORE II values. Unadjusted comparisons of cardiopulmonary bypass and aortic cross-clamp times, conversion to sternotomy, ventilation duration, intensive care unit and hospital length of stay, drainage volume, and transfusion requirements yielded p values > 0.05. In adjusted analyses of the four selected outcomes, all 95% confidence intervals for the BMI-group estimates included zero. Pneumonia was numerically more frequent in patients with BMI ≥ 30 kg/m2 (10.4% vs. 2.6% and 1.7%), but the estimates were imprecise. In-hospital mortality was low, with one death overall. Only eight patients had BMI ≥ 35 kg/m2. Conclusions: Among patients considered suitable for robotic MVR, the adjusted estimates showed no statistically detectable association between BMI category and the selected early outcomes. However, the confidence intervals did not establish equivalence, and the findings apply only to selected robotic surgical candidates.
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BibTeX
@article{apaydın2026isolated,
title = {{Isolated Robotic Mitral Valve Replacement Across Body Mass Index Categories: Early Perioperative Outcomes}},
author = {Zinar Apaydın and Barış Timur and Batuhan Yazıcı and Mustafa Can Kaplan and Salih Güler and İsa Can and Tural Muradlı and Safa Göde and Ersin Kadiroğulları},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197756},
url = {https://europepmc.org/article/PMC/PMC13666070},
note = {CC BY},
}
RIS
TY - JOUR
TI - Isolated Robotic Mitral Valve Replacement Across Body Mass Index Categories: Early Perioperative Outcomes
AU - Zinar Apaydın
AU - Barış Timur
AU - Batuhan Yazıcı
AU - Mustafa Can Kaplan
AU - Salih Güler
AU - İsa Can
AU - Tural Muradlı
AU - Safa Göde
AU - Ersin Kadiroğulları
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197756
UR - https://europepmc.org/article/PMC/PMC13666070
AB - Background: Obesity may pose additional technical and perioperative challenges in robotic mitral valve surgery. This study evaluated early perioperative outcomes of isolated robotic mitral valve replacement (MVR) across BMI categories. Methods: We retrospectively analyzed 146 patients who underwent isolated robotic MVR at a single center, categorized into BMI categories of <25 kg/m2 (n = 60), 25.0–29.9 kg/m2 (n = 38), or ≥30 kg/m2 (n = 48). Preoperative characteristics, operative variables, and early postoperative outcomes were compared among groups. The study was exploratory. Four clinically selected outcomes, cardiopulmonary bypass time, ventilation duration, hospital length of stay, and postoperative left ventricular ejection fraction, were evaluated using adjusted median quantile regression with bootstrap 95% confidence intervals, and multiplicity across postoperative outcomes was addressed using the Benjamini–Hochberg false discovery rate. Results: Patients with BMI ≥ 30 kg/m2 were older and had a higher prevalence of diabetes and higher EuroSCORE II values. Unadjusted comparisons of cardiopulmonary bypass and aortic cross-clamp times, conversion to sternotomy, ventilation duration, intensive care unit and hospital length of stay, drainage volume, and transfusion requirements yielded p values > 0.05. In adjusted analyses of the four selected outcomes, all 95% confidence intervals for the BMI-group estimates included zero. Pneumonia was numerically more frequent in patients with BMI ≥ 30 kg/m2 (10.4% vs. 2.6% and 1.7%), but the estimates were imprecise. In-hospital mortality was low, with one death overall. Only eight patients had BMI ≥ 35 kg/m2. Conclusions: Among patients considered suitable for robotic MVR, the adjusted estimates showed no statistically detectable association between BMI category and the selected early outcomes. However, the confidence intervals did not establish equivalence, and the findings apply only to selected robotic surgical candidates.
SN - 2077-0383
ER -