Application of minimally invasive approaches based on densitometric parameters in the surgical treatment of cardiac surgery patients

Objective. To improve the effectiveness of minimally invasive surgical approaches in cardiac surgery patients based on densitometric parameters. Material and methods. Eighty-seven patients after cardiac surgery were divided into five groups according to surgical access, presence of mediastinitis, and use of strontium ranelate and calcium with vitamin D3. Bone mineral density of the sternum and distal radius was assessed by ultrasound densitometry (Sunlight Omnisense 7000) using speed of sound, T-score and Z-score. Results. Patients with purulent mediastinitis and sternal instability demonstrated pronounced sternal osteopenia and early osteoporosis. Administration of strontium ranelate and calcium reduced the prevalence of sternal osteopenia and osteoporosis from 35.4–41.7% to 8.4–20%. Conclusion. Ultrasound densitometry should be used as a screening tool when selecting surgical access; correction of bone metabolism disorders allows wider use of minimally invasive techniques and reduces postoperative complications.