To investigate the inflammatory recovery trajectories of minimally invasive cardiac surgery (MICS) compared to median sternotomy (MS) using the Systemic Inflammation Response Index (SIRI).
Approach:
Study Design: Retrospective cohort study reviewing patients undergoing elective mitral valve surgery from February 2022 to February 2024, with 89 matched pairs analyzed.
SIRI Evaluation: SIRI was evaluated at baseline, postoperative day (POD) 1, and POD 5, focusing on the inflammatory resolution velocity (ΔSIRI).
Statistical Analysis: Statistical significance was set at P < 0.05, and ROC analysis was used to assess the prognostic value of ΔSIRI for predicting postoperative pulmonary complications (PPCs).
Key Findings:
Both groups experienced an acute inflammatory surge on POD 1 with no significant difference in ΔSIRI values (P = 0.619).
By POD 5, the MICS group showed a significantly greater re-equilibration to baseline levels compared to the MS group (P < 0.001).
The MICS group had longer operative and cardiopulmonary bypass times but still demonstrated improved inflammatory clearance.
ΔSIRI on POD 1 was a good early-warning biomarker for PPCs for both surgical approaches.
Interpretation:
MICS may facilitate faster systemic inflammatory resolution compared to conventional sternotomy.
Limitations:
The study is retrospective and may have inherent biases.
The sample size, while matched, may limit generalizability.
Conclusion:
MICS may create a more favorable physiological environment for systemic inflammatory resolution.
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