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

Larsson, Mårten LU ; Nozohoor, Shahab LU orcid ; Ede, Jacob LU orcid ; Herou, Erik LU orcid ; Ragnarsson, Sigurdur LU ; Wierup, Per LU ; Zindovic, Igor LU and Sjögren, Johan LU (2024) In Scandinavian Cardiovascular Journal 58(1).
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... (More)

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.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coagulopathy, inflammatory response, Minimally invasive surgery, mitral valve repair, ROTEM
in
Scandinavian Cardiovascular Journal
volume
58
issue
1
article number
2347293
publisher
Taylor & Francis
external identifiers
  • scopus:85195631512
  • pmid:38832868
ISSN
1401-7431
DOI
10.1080/14017431.2024.2347293
language
English
LU publication?
yes
id
468a6237-17ee-44de-ba4e-d3b2f5e16d2c
date added to LUP
2024-09-16 11:41:21
date last changed
2024-12-24 00:33:30
@article{468a6237-17ee-44de-ba4e-d3b2f5e16d2c,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Larsson, Mårten and Nozohoor, Shahab and Ede, Jacob and Herou, Erik and Ragnarsson, Sigurdur and Wierup, Per and Zindovic, Igor and Sjögren, Johan}},
  issn         = {{1401-7431}},
  keywords     = {{coagulopathy; inflammatory response; Minimally invasive surgery; mitral valve repair; ROTEM}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Biomarkers of inflammation and coagulation after minimally invasive mitral valve surgery : a prospective comparison to conventional surgery}},
  url          = {{http://dx.doi.org/10.1080/14017431.2024.2347293}},
  doi          = {{10.1080/14017431.2024.2347293}},
  volume       = {{58}},
  year         = {{2024}},
}