ArticleFrontiers in cardiovascular medicine2026
Does sternal-sparing outweigh prolonged bypass? inflammatory resolution in MICS versus median sternotomy: a SIRI-based analysis.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Systemic inflammatory response is an important biological factor that determines morbidity after cardiac interventions. Minimally invasive cardiac surgery (MICS) was conceived to reduce surgical trauma but the subtle dynamics of its effect on the clearance of systemic inflammation is an ongoing research target. The aim of the present study was to investigate divergent inflammatory recovery trajectories of MICS and traditional MS with a multidimensional surrogate marker of immunological stress, the Systemic Inflammation Response Index (SIRI). Methods: This retrospective cohort study reviewed patients undergoing elective mitral valve surgery between February 2022 and February 2024; of 269 initially identified patients, 235 were eligible, and propensity score matching yielded 89 matched pairs for analysis. SIRI (combination of neutrophils × monocytes/lymphocytes) was evaluated at baseline, postoperative day (POD) 1 and POD 5. The main endpoint was the "inflammatory resolution velocity" measured by relative change from baseline (ΔSIRI). Results: Our data showed that there was an acute and uniform inflammatory surge in both groups on POD 1 with no significant statistical divergence ( Conclusion: MICS may reduce systemic inflammatory resolution time, defined by the kinetic of SIRI, creating optimal physiological environment for systemic inflammatory resolution, which may accelerate functional recovery and cardiac rehabilitation after MICS vs. conventional sternotomy. The data suggests a possible biological basis of sternal sparing techniques with regard to the "inflammatory window" and patient oriented outcomes.
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