Language
English
Publication Date
4-1-2025
Journal
JTCVS Open
DOI
10.1016/j.xjon.2025.02.004
PMID
40309703
PMCID
PMC12039384
PubMedCentral® Posted Date
2-14-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Objective: Obesity can complicate surgical repair, but its relationship to outcomes after open thoracoabdominal aortic aneurysm (TAAA) repair remains uncertain. Therefore, we examined whether obesity is associated with greater operative risk after elective TAAA repair.
Methods: We retrospectively evaluated data from 2517 open, elective, single-practice TAAA repairs (from 1986 to 2023) and compared patients without obesity or underweight (body mass index [BMI] 18.6-29.9; n = 1977) with patients with obesity (BMI ≥30; n = 540 [21.5%]). Multivariable logistic regression modeling identified predictors of operative mortality in patients with obesity. We created propensity-matched cohorts (n = 540 pairs) and compared their early and late outcomes, including late survival, by Kaplan-Meier analysis and log-rank testing.
Results: Compared with patients without obesity, patients with obesity were younger (median age, 64 years [Q1-Q3: 56-71] vs 68 [59-73] years; P < .001) and had greater rates of aortic dissection (45.7% vs 34.5%; P < .001) and diabetes (13.1% vs 6.9%; P < .001). Extent I repairs were more frequent in patients with obesity (30.6% vs 24.9%; P = .008). Operative mortality did not differ between groups (5.6% vs 6.6%; P = .9); however, persistent stroke was more frequent in patients with obesity (3.7% vs 2.0%, P = .02). Overall, BMI was not associated with operative mortality; within the patients with obesity, multivariable modeling found aortic dissection was independently associated with operative mortality. Propensity matching revealed no substantial differences in examined outcomes.
Conclusions: Patients with obesity undergoing TAAA repair differed from their counterparts without obesity regarding several factors. However, adjusted early outcomes after TAAA replacement did not differ by the presence or severity of obesity. We conclude that obesity alone should not deter surgeons from offering elective TAAA repair.
Keywords
aortic aneurysm, thoracoabdominal aorta, aortic dissection, obesity, surgery, outcomes
Published Open-Access
yes
Recommended Citation
Zeigler, Sanford; Blackburn, Kyle W; Tabatabaeishoorijeh, Ahmad; et al., "Obesity and Outcomes After Elective Thoracoabdominal Aortic Aneurysm Repair" (2025). Faculty, Staff and Students Publications. 6146.
https://digitalcommons.library.tmc.edu/baylor_docs/6146