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Obesity Does Not Influence the Outcomes of Minimally Invasive Mitral Valve Repair for Mitral Regurgitation: A

Piotr Mazur1,2, Ibrahim Gadelkarim1, Mateo Marin-Cuartas1

  • 1University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig 04289, Germany.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 12, 2026
PubMed
Abstract

Insights

Obesity does not impact outcomes after minimally invasive mitral valve repair (MI-MVr). However, conditions like diabetes, chronic lung disease, and reduced left ventricular ejection fraction significantly affect long-term survival in these patients.

Area of Science:

  • Cardiovascular Surgery
  • Obesity Medicine
  • Surgical Outcomes Research

Background:

  • Limited data exist on the long-term effects of obesity in patients undergoing minimally invasive cardiac surgery.
  • Longitudinal outcomes after minimally invasive mitral valve repair (MI-MVr) in obese individuals are not well-documented.

Purpose of the Study:

  • To compare the overall survival rates of obese patients versus normal-weight patients after MI-MVr.
  • To identify factors influencing long-term mortality in patients who have undergone MI-MVr.

Main Methods:

  • A retrospective analysis utilizing propensity-score matching.
  • Comparison of outcomes between obese (body mass index [BMI] ≥30 kg/m2) and normal-weight (BMI 19-25 kg/m2) patients who underwent MI-MVr.
  • Median follow-up of 9.3 years, with actuarial survival assessed at 15 years.

Main Results:

  • No significant differences in overall survival were observed between obese and normal-weight patients at 15 years (59% vs. 57%).
  • Obese patients had slightly longer operative and cardiopulmonary bypass times but similar cross-clamp times and early complication rates.
  • Independent predictors of mortality included diabetes, chronic lung disease, left ventricular ejection fraction <50%, and older age.

Conclusions:

  • Obesity itself is not a significant determinant of outcomes following MI-MVr.
  • Comorbidities such as diabetes, chronic lung disease, and impaired cardiac function are critical factors affecting long-term survival after MI-MVr.
Keywords:
cardiac surgeryminimally invasivemitral valve repairobesityoutcomes

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