Abstract
Surgical aortic valve replacement represents a class one indication in the setting of aortic valve endocarditis and decompensated heart failure secondary to aortic regurgitation as per the European Society of Cardiology. However, extreme obesity, whereby the body mass index (BMI) >40 kg/m2, represents a challenging cohort of patients. Performing cardiac surgery in the bariatric population is fraught with challenges pertaining to intraoperative issues of surgical access and approach. We describe the case of a 45-year-old gentleman who had previous been diagnosed with infective endocarditis of the aortic valve and with a BMI of 68.2 (228 kg). Surgical aortic valve replacement in extreme obesity is associated with deep sternal wound infection, requirement and duration of mechanical ventilation, atrial fibrillation and renal failure. The ‘obesity paradox’ of overweight and class I obesity (BMI <35) has demonstrated favourable long-term results compared with underweight patients or even those with normal BMI undergoing cardiac surgery.
Original language | English |
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Article number | rjac149 |
Number of pages | 3 |
Journal | Journal of Surgical Case Reports |
Volume | 2022 |
Issue number | 4 |
DOIs | |
Publication status | Published - 12 Apr 2022 |
Keywords
- heart failure
- acute
- aortic value
- aortic value insufficiency
- atrial fibrillation
- obesity
- bacterial endocarditis
- body mass index procedure
- cardiac surgery procedures
- congestive heart failure
- aortic valve replacement
- endocarditis