Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■微创心脏手术技术的使用越来越多，但体外循环时间更长，这可能会增加炎症反应并对凝血产生负面影响。我们的目的是比较使用常规胸骨切开术的微创二尖瓣修复和二尖瓣手术后炎症和凝血的生物标志物以及输血率。
一项前瞻性非随机研究纳入了71例接受二尖瓣手术的患者（35例右开胸手术和36例常规胸骨切开术）。术前和术后收集血样以评估炎症反应。进行血栓弹性测量(ROTEM)以评估凝血,并监测输血率。
与胸骨切开术组相比，微创组的体外循环时间更长：127分钟（[115-146]vs79分钟[65-112]，p<0.001），并在体外循环期间冷却至较低温度，34°Cvs36°C(p=0.04)。在手术结束时测量，与常规胸骨切开术组相比，微创组的IL-6较低，（38[23-69]vs61[41-139]，p=0.008),但在术后第1天或术后第3天未发现差异。微创组的输血率（14％）低于全胸骨切开术（35％，p=0.04)，胸管输出减少，（395毫升[190-705]对570毫升[400-1040]，p=0.04)。
■我们的数据显示，尽管在手术过程中使用额外的体循环时间更长，微创二尖瓣修复术与炎症反应减少有关，较低的输血率，减少胸管输出。
一项前瞻性非随机研究纳入了71例接受二尖瓣手术的患者（35例右开胸手术和36例常规胸骨切开术）。术前和术后收集血样以评估炎症反应。进行血栓弹性测量(ROTEM)以评估凝血,并监测输血率。
与胸骨切开术组相比，微创组的体外循环时间更长：127分钟（[115-146]vs79分钟[65-112]，p<0.001），并在体外循环期间冷却至较低温度，34°Cvs36°C(p=0.04)。在手术结束时测量，与常规胸骨切开术组相比，微创组的IL-6较低，（38[23-69]vs61[41-139]，p=0.008),但在术后第1天或术后第3天未发现差异。微创组的输血率（14％）低于全胸骨切开术（35％，p=0.04)，胸管输出减少，（395毫升[190-705]对570毫升[400-1040]，p=0.04)。
■我们的数据显示，尽管在手术过程中使用额外的体循环时间更长，微创二尖瓣修复术与炎症反应减少有关，较低的输血率，减少胸管输出。
