{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T02:07:47Z","timestamp":1771380467735,"version":"3.50.1"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In obese patients, minimally invasive surgical aortic valve replacement (MIS-AVR) presents challenges, and the risk of patient\u2013prosthesis mismatch (PPM) is elevated. This retrospective single-center study evaluates the impact of body mass index (BMI) on the outcome of an initial MIS-AVR program.<\/jats:p>\n                  <jats:p>A total of 307 patients underwent MIS-AVR between January 2013 and December 2015, the initial phase of our MIS-AVR program. They were divided into normal\/overweight (BMI &lt;30\u2009kg\/m2) versus obese patients (BMI \u226530\u2009kg\/m2). Primary endpoints included 30-day and 2-year mortality and stroke. Secondary endpoints comprised type 3 bleeding, PPM, paravalvular leakage, wound healing disorders (WHDs), and pacemaker rates.<\/jats:p>\n                  <jats:p>In all 191 patients exhibited a BMI &lt;30\u2009kg\/m2, while 116 patients had a BMI \u226530\u2009kg\/m2. The BMI groups did not differ in baseline characteristics, excepting a higher peripheral arterial disease incidence among obese patients (15.7% vs. 26.7%; p\u2009=\u20090.01). Aortic clamp time (75\u2009\u00b1\u200929\u2009min vs. 87\u2009\u00b1\u200937\u2009min; p\u2009=\u20090.001), cardiopulmonary bypass (104\u2009\u00b1\u200936\u2009min vs. 124\u2009\u00b1\u200956\u2009min; p\u2009=\u20090.0002), and ventilation times (26\u2009\u00b1\u20096\u2009h vs. 44\u2009\u00b1\u20098\u2009h; p\u2009=\u20090.03) were longer in obese patients. They demonstrated a higher risk for bleeding (2.6% vs. 9.5%; p\u2009=\u20090.008) but lower pacemaker rates (9% vs. 3%; p\u2009=\u20090.02). PPM, paravalvular leakage, and WHD exhibited no group differences. No BMI-related differences revealed in 30-day mortality (4.7% vs. 3.4%) and stroke rates (2% vs. 2.6%), as well as 2-year mortality (12.6% vs. 11.2%) and stroke rates (2.1% vs. 2.6%).<\/jats:p>\n                  <jats:p>In the initial phase of an MIS-AVR program, the 30-day mortality may be elevated. Despite longer operative times and an increased risk for bleeding in obese patients, no influence of BMI on postoperative morbidity, mortality, or stroke rates was observed.<\/jats:p>","DOI":"10.1055\/a-2498-2031","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T19:32:29Z","timestamp":1737401549000},"page":"147-154","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Body Mass Index on the Initial Phase of a Minimally Invasive Aortic Valve Program"],"prefix":"10.1055","volume":"74","author":[{"given":"Elias","family":"Ewais","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadja","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Statistics, Technical University Dortmund, Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Schl\u00f6micher","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Bechtel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadim","family":"Moustafine","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazha","family":"Hamdani","sequence":"additional","affiliation":[{"name":"Department of Cellular and Translational Physiology, Ruhr-Universitat Bochum, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justus T.","family":"Strauch","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1884-3498","authenticated-orcid":false,"given":"Peter Lukas","family":"Haldenwang","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Herz- und Thoraxchirurgie, Berufsgenossenschaftliches Universit\u00e4tsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/ejcts\/ezt616","article-title":"Ministernotomy versus conventional sternotomy for aortic valve replacement: matched propensity score analysis of 808 patients","volume":"46","author":"N Furukawa","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/ejcts\/ezu068","article-title":"Minimal invasive aortic valve replacement surgery is associated with improved survival: a propensity-matched comparison","volume":"47","author":"D R Merk","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref4","first-page":"160","article-title":"Challenges and outcomes of minimally invasive aortic valve replacement: a comprehensive review","volume":"4","author":"M 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