Comparison of inflammation reaction and myocardial injury between totally thoracoscopic procedure and thoracotomy tricuspid valve procedure

  AIM  To compare the inflammatory response and myocardial injury markers in patients receiving totally thoracoscopic or thoracotomy tricuspid valve surgery.

  METHODS  We retrospectively analyzed 88 patients (males 53, average age 49±19 years, left ventricular ejection fraction 63±6%) with tricuspid valve diseases who came to our hospital for surgical treatment (72 cases for tricuspid valve plasty) between January 2018 and April 2019. A total of 56 patients received totally thoracoscopic procedure (50 cases for tricuspid valve plasty) and 32 cases received thoracotomy procedure. All patients underwent tricuspid valve surgery as single valve procedure. The leukocyte and C-reactive protein (CRP) levels were collected as indicators of systemic inflammatory reaction. The lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), aspartate aminotransferase (AST) and troponin T(cTnT) were collected as markers of myocardial injury.

  RESULTS  There was no statistical difference in the above mentioned indicators and markers on admission between the two groups. The systemic inflammatory reaction of both groups reached its peak on the 2nd day after operation and gradually decreased thereafter. Inflammation indexes and myocardial injury marker levels of patients in totally thoracoscopic approach group were significantly lower than those in sternotomy approach group.

  CONCLUSION  Compared with thoracotomy tricuspid valve procedure, totally thoracoscopic tricuspid valve procedure can significantly reduce postoperative myocardial injury and systemic inflammatory response.