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Mid-Term Outcomes of Valve Replacement Surgery With or Without Coronary Artery Bypass Grafting in Patients With Overweight and Obesity: A Cohort Study Publisher Pubmed



Rajablou N1 ; Tashak Golroudbari H1 ; Ahmadi Tafti SH2 ; Bagheri J3 ; Zoroufian A3 ; Sahebjam M3 ; Salehbeigi S3 ; Lesani Z4 ; Omidi N4
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Clinical Obesity Published:2025


Abstract

Current data evaluating outcomes of valve replacement surgery in patients with overweight/obesity is contradictory. There is a scarce study comparing outcomes of valve surgery considering the type of valve involved in the procedure. We followed outcomes in patients with overweight and obesity after valve replacement surgery with or without coronary artery bypass graft (CABG) and also patients with aortic valve replacement (AVR) and mitral valve replacement (MVR), separately to compare their mid-term prognosis in each group. Consecutive patients who had undergone cardiac valve surgery with or without CABG in Tehran Heart Center were enrolled. We enrolled 3158 patients. Median survival was 125.71 ± 82.20 weeks in patients with overweight/obesity. We found a significantly higher LVDd, LVDs and RVDd in patients with CABG (51.85 ± 7.31, 36.80 ± 8.81 and 30.04 ± 3.58, respectively) compared to the valve group (50.10 ± 6.35 mm, 35.08 ± 7.29 mm and 29.76 ± 4.07 mm, respectively). All-cause mortality is significantly higher in patients with AVR (5.7%) than those with MVR (3.3%). Patients with CABG are at higher risk of myocardial infarction (MI) compared to the ones without CABG (0.8% vs. 0.1%). No significant interaction was observed between the type of valve surgery (AVR/MVR) or valve surgery combinations (valve/valve + CABG) (p-values =.81 vs.97, respectively). Post-operative outcomes in patients with overweight/obesity depend on several factors such as type of valve involved and presence of CABG. Risk management can lower the rate of mortality and morbidity in these patients. © 2024 World Obesity Federation. Published by John Wiley & Sons Ltd.
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