Effect of different surgical approaches to aortic valve replacement on surgical stress degree and systemic inflammatory response

A.V. Іvanyuk, M.V. Bondar, O.A. Loskutov, A.V. Rudenko, B.M. Todurov


The aim of the study was to estimate the effect of minimally invasive J-shaped sternotomy and median sternotomy on the intensity of surgical stress and systemic inflammatory response in aortic valve replacement. The results of the examination of 44 patients undergone minimally invasive approach and 54 patients undergone media sternotomy demonstrated that J-sternotomy was associated with less intensive systemic inflammatory response that has been proved by lower plasma concentrations of basic inflammatory cytokines (TNF-alpha on average 5.8 pg/ml (increased 1.6 times), IL-6 — on ave­rage 5.3 pg/mL (increased 2.3 times)), and some acute-phase proteins (C-reactive protein — on average 23.5 mg/l (increased 1.8 times) and fibrinogen concentrations — on average 1.3 g/l (increased 1.3 times)). As well it has been determined that minimally invasive approach to aortic valve replacement is followed by less severe stress-induced hormonal homeostasis as comparison to the standard median sternotomy, and it objectively confirms the benefits of minimally invasive approach versus media sternotomy.


aortic valve replacement; minimally invasive approaches; postoperative stress intensity; stress-induced disruptions of hormonal homeostasis


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