J Cardiothorac Surg. 2026 Jun 5. doi: 10.1186/s13019-026-04397-y. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aims to investigate the impacts of various body mass index (BMI) classifications on perioperative parameters and short-term outcomes in patients undergoing Da Vinci robot-assisted atrial septal defect (ASD) repair providing evidence for personalized perioperative management.
METHODS: A retrospective analysis was conducted on 100 patients who underwent Da Vinci robot-assisted ASD repair at Qingdao University Affiliated Hospital between November 2014 and December 2025. Based on the Chinese adult BMI classification criteria, the patients were categorized into four groups: underweight group (BMI < 18.5 kg/m², n = 9), normal weight group (18.5 ≤ BMI < 24.9 kg/m², n = 52), overweight group (25.0 ≤ BMI < 29.9 kg/m², n = 26), and obese group (BMI ≥ 30.0 kg/m², n = 13). This study compared baseline characteristics, intraoperative indicators, postoperative recovery, and short-term prognosis across these groups. Furthermore, multivariate logistic regression analyzed the independent associations of BMI classification and age with postoperative surgical site infection and hospital readmission.
RESULTS: No significant differences were observed among the four groups concerning baseline echocardiographic parameters, key intraoperative metrics (e.g., operation duration, cardiopulmonary bypass time), or most postoperative recovery measures (e.g., mechanical ventilation duration, length of intensive care unit stay), with all P > 0.05. No sternotomy conversion or early mortality occurred. Univariate analysis showed the obese group had significantly higher rates of surgical site infection (15.4%) and readmission (23.1%) (all P < 0.05), but multivariate regression did not identify BMI classification or age as independent predictors (all P > 0.05).
CONCLUSION: Da Vinci robot-assisted ASD repair is safe and effective across different BMI levels, with its minimally invasive nature appearing to mitigate weight-related surgical challenges within this cohort. Although obese patients face higher risks of postoperative infection and readmission, BMI was not found to be an independent influencing factor in this exploratory analysis; however, small subgroup sizes and sparse data limit the statistical reliability of this finding. Individualized enhanced perioperative management for obese populations is recommended, and weight status should not be a contraindication for this procedure.
PMID:42249473 | DOI:10.1186/s13019-026-04397-y
