Why the study?
Obesity is linked to adverse outcomes after cardiac procedures, but its relationship to outcomes after total aortic arch replacement remains unclear.
Does obesity increase the risk of operative mortality or adverse events in patients undergoing elective total aortic arch replacement?
Does obesity increase the risk of operative mortality or adverse events in patients undergoing elective total aortic arch replacement?
Obesity alone is not associated with increased operative mortality or adverse events after elective total aortic arch replacement, suggesting it should not be an absolute contraindication for the procedure.
Obesity alone should not exclude patients from TAR; leaves open need for prospective validation of risk stratification.
Objective: Obesity is a chronic disease linked to high mortality and morbidity after cardiac procedures, but its relationship to outcomes after total aortic arch replacement (TAR) remains unclear. We examined TAR data to determine whether obesity is associated with greater perioperative risk. Methods: ). The remaining 521 patients did not have obesity (18.5 ≤BMI <30; n = 389) or did (BMI ≥30; n = 132). Patients with obesity were class 1 (30 ≤ BMI < 35), class 2 (35 ≤ BMI < 40), or class 3 (BMI ≥40). We compared preoperative and perioperative variables for BMI ≥30 (obesity) versus BMI <30. Adverse events were operative mortality, persistent stroke, spinal cord deficit, and renal failure. We performed multivariable logistic regression and Kaplan-Meier survival analysis. Results: = .047) were. Survival did not differ significantly by obesity status. Conclusions: Obesity was not associated with operative mortality or adverse events in patients who underwent TAR. Therefore, patients should not be deemed ineligible for TAR on the basis of obesity alone.
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Orozco-Sevilla et al. (2026) studied this question.
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