Abstract
IntroductionThe thoracoscopic procedure for tricuspid valve (TV) diseases is a minimally invasive method of treatment. This study focuses on comparing the changes in postoperative inflammatory reaction and myocardial injury markers after thoracoscopic and sternotomy/thoracotomy TV procedures.MethodsWe retrospectively analyzed 88 patients (53 males, aged 50.9±16.2 years) with TV diseases (single-valve disease) (72 cases of TV plasty) between January 2018 and April 2019. A total of 56 patients underwent thoracoscopic procedure (50 cases of TV plasty). The leukocyte and C-reactive protein (CRP) levels were monitored as indicators of systemic inflammatory reaction. The lactate dehydrogenase, creatine kinase, creatine kinase myocardial band, aspartate aminotransferase, and troponin-T levels were recorded as markers of myocardial injury.ResultsThe CRP and white blood cells levels of patients in the sternotomy approach group were continuously higher than those in patients in the thoracoscopic approach group. And the levels of myocardial enzymes in patients in the thoracoscopic approach group were significantly lower than those in patients in the sternotomy approach group.ConclusionCompared with sternotomy/thoracotomy procedures on TV, the thoracoscopic procedure can reduce postoperative myocardial injury significantly and systemic inflammatory reaction to a certain extent. It is technically feasible, safe, effective, and worthy of widespread adoption in clinical practice.
Highlights
The thoracoscopic procedure for tricuspid valve (TV) diseases is a minimally invasive method of treatment
Several kinds of minimally invasive access for TV procedures in adult patients have been popularly introduced into clinical practice
TV surgery (TVS) through lower hemisternotomy and right lateral minithoracotomy were safe approaches with very low operative mortality compared to standard median sternotomy[1,2]
Summary
The thoracoscopic procedure for tricuspid valve (TV) diseases is a minimally invasive method of treatment. This study focuses on comparing the changes in postoperative inflammatory reaction and myocardial injury markers after thoracoscopic and sternotomy/thoracotomy TV procedures. Accumulating knowledge of the structure, function, and pathology of tricuspid valve (TV) has led to favourable surgical results in TV procedures. Advances in imaging and surgical instruments have allowed surgeons to perform less invasive sternum-sparing TV surgery (TVS). Several kinds of minimally invasive access for TV procedures in adult patients have been popularly introduced into clinical practice. TVS through lower hemisternotomy and right lateral minithoracotomy were safe approaches with very low operative mortality compared to standard median sternotomy[1,2].
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