Assessment of Coagulopathy Using Thromboelastometry in Patients Undergoing Mitral Valve Surgery
Project no. 23372 · Status: Kapanmış (Yayın bekleniyor) · 2022
Summary
<p><br></p><p><br></p><p>Mitral valve surgery is associated with bleeding and blood product usage, both of which have a direct impact on patient morbidity and mortality. Conventionally, mitral valve procedures are performed via median sternotomy. However, minimally invasive mitral valve surgery (MIMVS), conducted through right thoracotomy with thoracoscopic assistance, is thought to reduce surgical trauma and is therefore associated with lower rates of bleeding and transfusion requirements.</p><p><br></p><p>Despite these potential advantages, the effect of surgical approach on coagulopathy remains unclear. Thromboelastometry (ROTEM) is a sensitive and specific tool for assessing the functional status of coagulation pathways and allows for the detection of perioperative coagulopathy, particularly after cardiac surgery.</p><p><br></p><p>This prospective, comparative study aims to investigate the relationship between the surgical approach (sternotomy vs. thoracotomy) and the development of coagulopathy in patients undergoing mitral valve surgery. A total of 48 patients will be included, with 24 patients in each group. Preoperative characteristics, intraoperative variables, and postoperative outcomes will be recorded for both cohorts.</p><p><br></p><p>Thromboelastometric analysis will be performed intraoperatively following protamine sulfate administration in all patients to evaluate the presence and type of coagulopathy. Based on these results, targeted transfusion therapy will be implemented.</p><p><br></p><p>The <strong>primary aim</strong> of the study is to analyze the type and frequency of coagulopathy associated with each surgical technique. The <strong>secondary aim</strong> is to compare clinical outcomes, including morbidity and mortality, in relation to coagulopathy findings.</p>