Journal of Cardiothoracic and Vascular Anesthesia · Nov 2026
Association Between Body Mass Index and Outcomes in Transcatheter Aortic Valve Replacement Patients: a Statewide Cohort Study
By Mazzeffi M, McNeil J, Saxon JT et al.
Objectives The aim of our study was to explore whether body mass index (BMI) was associated with major complications or 30-day mortality after transcatheter aortic valve replacement (TAVR). Design Retrospective cohort study. Setting Ten Virginia hospitals. Participants TAVR patients. Interventions None. Measurements and Main Results BMI was modeled as an exposure and the primary outcome was a composite of major complications or 30-day mortality. One-year mortality was a secondary outcome. Generalized linear mixed models were fit with hospital modeled as a random intercept. Overall, BMI had no association with major complications or 30-day mortality in 8,489 TAVR patients (omnibus p=0.33). Patients who had a BMI of 30-34.9 kg/m² (obesity class I) had slightly increased odds of major complications or 30-day mortality compared to normal BMI patients, OR=1.27 (95% CI=1.04 to 1.55), p=.02. However, patients with a BMI of 35-39.9 kg/m² (obesity class II) and patients with a BMI >40 kg/m² (obesity class III) did not have higher odds of major complications or 30-day mortality, OR=1.16 (95% CI=0.89 to 1.50), p=.27 and OR=1.20 (95% CI=0.89 to 1.61), p=.24 respectively. For one-year mortality, patients with a BMI of 25-29.9 kg/m2 (overweight), 30-34.9 kg/m2 (obesity class I), and 35-39.9 kg/m2 (obesity class II) had lower odds of mortality compared to normal BMI patients (all p<.05). Conclusions Our analysis suggests that obesity is not a significant risk factor for major complications or 30-day mortality after TAVR, while at one-year patients who were overweight or obesity class I or II had improved survival.