Biomarkers of inflammation and coagulation after minimally invasive mitral valve surgery: a prospective comparison to conventional surgery.

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  • Additional Information
    • Source:
      Publisher: Taylor & Francis Country of Publication: England NLM ID: 9708377 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1651-2006 (Electronic) Linking ISSN: 14017431 NLM ISO Abbreviation: Scand Cardiovasc J Subsets: MEDLINE
    • Publication Information:
      Publication: 2015- : Abingdon, Oxford : Taylor & Francis
      Original Publication: Oslo ; Boston : Scandinavian University Press, c1997-
    • Subject Terms:
      Biomarkers*/blood ; Mitral Valve*/surgery ; Mitral Valve*/physiopathology ; Inflammation Mediators*/blood ; Cardiopulmonary Bypass*/adverse effects ; Blood Coagulation* ; Blood Transfusion* ; Sternotomy*/adverse effects ; Thoracotomy*/adverse effects; Humans ; Prospective Studies ; Female ; Male ; Middle Aged ; Aged ; Treatment Outcome ; Time Factors ; Thrombelastography ; Interleukin-6/blood ; Inflammation/blood ; Inflammation/etiology ; Inflammation/diagnosis ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Diseases/surgery ; Heart Valve Diseases/blood ; Risk Factors
    • Abstract:
      Objectives: Minimally invasive cardiac surgery techniques are increasingly used but have longer cardiopulmonary bypass time, which may increase inflammatory response and negatively affect coagulation. Our aim was to compare biomarkers of inflammation and coagulation as well as transfusion rates after minimally invasive mitral valve repair and mitral valve surgery using conventional sternotomy.
      Design: A prospective non-randomized study was performed enrolling 71 patients undergoing mitral valve surgery (35 right mini-thoracotomy and 36 conventional sternotomy procedures). Blood samples were collected pre- and postoperatively to assess inflammatory response. Thromboelastometry (ROTEM) was performed to assess coagulation, and transfusion rates were monitored.
      Results: The minimally invasive group had longer cardiopulmonary bypass times compared to the sternotomy group: 127 min ([115-146] vs 79 min [65-112], p  < 0.001) and were cooled to a lower temperature during cardiopulmonary bypass, 34 °C vs 36 °C ( p  = 0.04). IL-6 was lower in the minimally invasive group compared to the conventional sternotomy group when measured at the end of the surgical procedure, (38 [23-69] vs 61[41-139], p  = 0.008), but no differences were found at postoperative day 1 or postoperative day 3. The transfusion rate was lower in the minimally invasive group (14%) compared to full sternotomy (35%, p  = 0.04) and the chest tube output was reduced, (395 ml [190-705] vs 570 ml [400-1040], p  = 0.04).
      Conclusions: Our data showed that despite the longer use of extra corporal circulation during surgery, minimally invasive mitral valve repair is associated with reduced inflammatory response, lower rates of transfusion, and reduced chest tube output.
    • Contributed Indexing:
      Keywords: Minimally invasive surgery; ROTEM; coagulopathy; inflammatory response; mitral valve repair
    • Accession Number:
      0 (Biomarkers)
      0 (Inflammation Mediators)
      0 (Interleukin-6)
      0 (IL6 protein, human)
    • Publication Date:
      Date Created: 20240604 Date Completed: 20240604 Latest Revision: 20240604
    • Publication Date:
      20240604
    • Accession Number:
      10.1080/14017431.2024.2347293
    • Accession Number:
      38832868