Association Between Obesity and Early Outcomes After Minimally Invasive Coronary Artery Bypass Surgery: A Propensity Score-Matched Study

Background: The impact of obesity on outcomes following minimally invasive direct coronary artery bypass (MIDCAB) and multivessel MIDCAB (MV-MIDCAB) remains incompletely understood. Methods: This retrospective, single-centre analysis included 383 patients with available body mass index (BMI) data: 275 non-obese patients (BMI < 30 kg/m2) and 108 obese patients (BMI ≥ 30 kg/m2). Propensity score matching based on available preoperative covariates yielded 105 matched pairs. Baseline balance was assessed using standardized mean differences (SMDs). Results: Multivessel MIDCAB was performed in 41.9% of obese and 44.8% of non-obese patients (p = 0.755), while complete revascularization was achieved in 32.4% and 33.3%, respectively (p = 1.000). Acute kidney injury occurred in 6.7% of obese and 3.8% of non-obese patients (p = 0.549), while postoperative delirium occurred in 8.7% and 5.7%, respectively (p = 0.581). Wound infection was documented in 3 obese patients (2.9%) and 1 non-obese patient (1.0%; risk difference, 1.9 percentage points; approximate 95% confidence interval [CI], −1.8 to 5.7; exact paired p = 0.625). In-hospital mortality occurred in 1 obese patient and no non-obese patients (risk difference, 1.0 percentage point; approximate 95% CI, −0.9 to 2.8; exact paired p = 1.000). Conclusions: No statistically significant differences in early outcomes were detected.