Renal function after port access and median sternotomy mitral valve surgery

Area of Science:

• Cardiac Surgery
• Nephrology
• Minimally Invasive Procedures

Background:

• Acute kidney injury is a significant postoperative complication following mitral valve surgery.
• Standard median sternotomy (MS) is a common surgical approach for mitral valve repair.
• Minimally invasive port access (PA) surgery is an alternative technique for mitral valve procedures.

Purpose of the Study:

• To investigate whether minimally invasive port access (PA) surgery leads to less postoperative renal injury compared to standard median sternotomy (MS) in mitral valve surgery.
• To compare renal function outcomes between PA and MS groups using creatinine clearance and RIFLE classification.

Main Methods:

• Retrospective comparison of 96 patients in the PA group and 102 patients in the MS group.
• Assessment of renal function using preoperative and maximal postoperative serum creatinine levels to calculate creatinine clearance.
• Utilized the RIFLE (Risk, Injury, Failure, Loss, End-stage renal disease) classification to evaluate postoperative kidney function.

Main Results:

• No significant differences in preoperative renal function markers between the PA and MS groups.
• Significantly lower minimal postoperative creatinine clearance observed in the MS group compared to the PA group.
• Multivariate analysis identified the conventional MS approach as an independent renal risk factor, with higher postoperative renal impairment noted in the MS group via RIFLE classification.

Conclusions:

• Minimally invasive port access (PA) surgery may be associated with reduced postoperative renal injury in mitral valve surgery compared to the conventional median sternotomy (MS) technique.
• The findings suggest PA surgery could be a safer alternative regarding renal outcomes, although further research is warranted due to the study's retrospective nature.