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Optimizing aortic valve prosthesis selection in patients with obesity: Institutional experience with

Ozan Onur Balkanay1, Halil Ibrahim Bulut2, Ergida Albrahimi1

  • 1Department of Cardiovascular Surgery Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Asian Cardiovascular & Thoracic Annals
|August 23, 2023
PubMed

Insights

For obese patients undergoing aortic valve replacement, neither bioprosthetic nor mechanical valves showed significant differences in outcomes. Careful consideration of valve choice is still recommended for this population.

Area of Science:

  • Cardiology
  • Surgical Innovation
  • Obesity Medicine

Background:

  • Aortic valve diseases are prevalent and life-threatening, with obesity as a significant risk factor.
  • Current guidelines lack specific management strategies for aortic valve disease in obese patients.
  • The optimal choice of prosthetic valve in obese individuals remains unclear.

Purpose of the Study:

  • To compare the outcomes of bioprosthetic versus mechanical aortic valve replacement in patients with obesity.
  • To evaluate perioperative characteristics and follow-up results in this specific patient cohort.

Main Methods:

  • A total of 130 obese patients underwent surgical aortic valve replacement.
  • Patients were divided into two groups: 50 received bioprosthetic valves, and 80 received mechanical valves.
  • Perioperative characteristics and follow-up results were compared between the groups.

Main Results:

  • No significant differences were observed in patient demographics, preoperative conditions, or intraoperative characteristics between the bioprosthetic and mechanical valve groups.
  • Postoperative outcomes, including mortality and acute kidney injury, did not significantly differ between the groups.
  • Intensive care unit (ICU) stays were shorter for bioprosthetic valve recipients, though not statistically significant.

Conclusions:

  • Valve selection for obese patients, especially those with class II obesity, requires careful consideration.
  • Obesity's impact on valve choice and the potential for future bariatric surgery should be factored into decisions.
Abstract

Keywords:
Aortic valvebioprostheticbloodcardiaccoagulation/anticoagulationegetc.)heart valve prosthesis (specify typemechanicalobesity (incl related subjects)replacement

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