Cost implications of mitral valve replacement versus repair in mitral regurgitation. Commentary.
Council on Cardio-Thoracic and Vascular Surgery, American Heart Association, Scientific Sessions. New Orleans, LA, USA, 1996/11/10.
Background Mitral valve repair and replacement (MVR) with preservation of the tendinous chordae [MVR (p) ], may have better results than MVR with valve excision [MVR (e) ]. It is not known whether the type of surgery affects in-hospital stay and cost.
Methods and Results We reviewed all patients who had mitral valve surgery for regurgitation over 5 years from January 1991.
Patients were considered in three groups ; MVR (e), MVR (p), and Repair.
Cost was calculated using operating room, intensive care unit, and ward expenses, not hospital charges.
There were a total of 253 patients ; 84 MVR (e), 42 MVR (p), and 127 Repair.
Mean ages and preoperative New York Heart Association (NYHA) classes were similar in the three groups.
There were more male patients in the Repair (62%) and MVR (p) (67%) groups than in the MVR (e) (44%) group (P<. 05), and more patients with degenerative etiology in the Repair group (P<. 01).
A majority of MVR (e) were in atrial fibrillation (63%), while 59% of Repair were in sinus rhythm (P<. 01).
Of 9 patients who died in the hospital ; four had MVR (e), 3 had MVR (p), and 2 had Repair.
In univariate analyses, in-hospital stay increased with patient age>70 years (P<. 01), preoperative atrial fibrillation (P<. 05), and NYHA class III or IV (P<. 01).
The median and interquartile ranges for postoperative stay was 10 (8 to 13) days for MVR (e), 8 (7 to 11) days for MVR (p), and 8 (7 to 10) days for Repair (P<. (...)
Mots-clés Pascal : Insuffisance mitrale, Valvule mitrale, Prothèse, Réparation, Homme, Excision, Cordage mitrale, Hospitalisation, Coût, Economie santé, Etude comparative, Traitement, Appareil circulatoire pathologie, Cardiopathie valvulaire, Chirurgie
Mots-clés Pascal anglais : Mitral regurgitation, Mitral valve, Prosthesis, Repair, Human, Excision, Mitral chordae tendinae, Hospitalization, Costs, Health economy, Comparative study, Treatment, Cardiovascular disease, Cardiac valvular disease, Surgery
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0055232
Code Inist : 002B25E. Création : 14/05/1998.