The ‘obesity paradox’ has been observed across a variety of surgical procedures, whereby patients with higher body mass index (BMI) have lower postoperative mortality compared to patients with low or normal BMI, theoretically due to a higher physiological reserve. This has also been observed in transcatheter aortic valve implantation (TAVI) cohorts, however the evidence is not consistent [1Yamamoto M. Mouillet G. Oguri A. Gilard M. Laskar M. Eltchaninoff H. et al.Effect of body mass index on 30- and 365-day complication and survival rates of transcatheter aortic valve implantation (from the FRench Aortic National CoreValve and Edwards 2 [FRANCE 2] registry).The American journal of cardiology. 2013; 112: 1932-1937Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar, 2Konigstein M. Havakuk O. Arbel Y. Finkelstein A. Ben-Assa E. Leshem Rubinow E. et al.The obesity paradox in patients undergoing transcatheter aortic valve implantation.Clinical cardiology. 2015; 38: 76-81Crossref PubMed Scopus (41) Google Scholar, 3Abramowitz Y. Chakravarty T. Jilaihawi H. Cox J. Sharma R.P. Mangat G. et al.Impact of body mass index on the outcomes following transcatheter aortic valve implantation.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2016; 88: 127-134Crossref PubMed Scopus (17) Google Scholar, 4van der Boon R.M. Chieffo A. Dumonteil N. Tchetche D. Van Mieghem N.M. Buchanan G.L. et al.Effect of body mass index on short- and long-term outcomes after transcatheter aortic valve implantation.The American journal of cardiology. 2013; 111: 231-236Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar]. This study reports postoperative outcomes by BMI for a cohort of TAVI patients at an Australian centre All patients who underwent TAVI at a single centre from 2008 to 2019 were reviewed in a retrospective registry analysis. Demographics including BMI and procedural outcomes (according to VARC2 definitions) were analysed. The primary outcome was mortality at 30-days and 1 year. Secondary outcomes were as listed in Table 1. Of 522 patients, 385 had available BMI data. Mean BMI was 27.3 (15.6 – 49.4); 26% (100) were overweight or obese (BMI ≥30). The rates of complications by BMI are displayed in Table 1. Results did not support the ‘obesity paradox’ with equal outcomes regardless of BMI, except requirement for PPM post TAVI.Tabled 1BMI <30 (n=285)BMI ≥30 (n=100)P–value30-day mortality (n)2% (5)1% (1)0.6001-year mortality (n)0.4% (16)8% (8)0.396Permanent Pacemaker (n)2.5% (7)8.6% (8)0.030Stroke (n)2.5% (7)6.3% (6)0.109Vascular complications (n)6.9% (17)4% (4)0.611Bleeding (n)11% (27)3% (3)0.049Length of stay (days)Mean 9.4±8.1Mean 10.1±17.30.333ICU length of stay (hours)Mean 36.1±40.6Mean 34.0±26.60.636 Open table in a new tab