Methods and Results:
Out of 439 patients undergoing MV surgery from January 2005 to May 2017,
345 patients were included after propensity-matching: 95 sternotomy
patients and 250 MIVT patients. Endpoints focused on survival, quality
of MV repair and organ function effects through analysis of biomarkers
and functional parameters.
Regardless of longer cardiopulmonary bypass(sternotomy: 96.0(IQR34)min
– MIVT:134.0(IQR42)min, p<0.001) and cardioplegic arrest
times(sternotomy: 61.0(IQR26)min – MIVT:87.0(IQR34)min,
p<0.001), no differences in survival nor complication rate
were found. Effect on renal function(creatinine, p=0.751 – ureum,
p=0.538 - glomerular filtration, p=0.848), myocardial damage by
troponine I level (sternotomy:1.8±3.9ng/ml – MIVT:1.2±1.3ng/ml,
p=0.438) and prolonged ventilatory support > 24
hours(sternotomy:5.5% - MIVT:9.5%, p=0.240) were comparable. Systemic
inflammatory reaction by postoperative CRP count was markedly lower for
MIVT(p<0.001). Increased rhadomyolysis was found after MIVT
surgery, based on significant elevation of creatinine-kinase
levels(sternotomy: 431±237U/L – MIVT: 701±595U/L, p<0.001).