The clinical and financial impact of port-access coronary revascularization.
OBJECTIVE
Port-access coronary bypass grafting (CABG)was performed in an attempt to impact the clinical course of patients with coronary artery disease.


METHODS
One hundred patients (56 men and 44 women) with a median age of 61 years underwent port-access coronary revascularization. The clinical and financial profiles of these patients were compared with fiscal year 1997 patients (n = 531) who underwent standard median sternotomy coronary bypass.


RESULTS
Preoperative clinical demographics were similar in both groups of patients. Among the port-access population there were no incidences of aortic dissection, deep vein thrombosis, conversion to median sternotomy, or death. Total time in the Intensive Care Unit (ICU), incidence of atrial fibrillation, transfusion requirements, and (subjective) pain rating at 28 days postoperatively were less in the port-access group. The average hospital cost per case was $2703.00 (US dollars) more in the port-access patients, despite a similar length of stay versus conventional sternotomy patients.


CONCLUSIONS
Coronary bypass surgery can be performed safely with port-access technology with significant clinical benefits in selected patients. Currently these benefits are attained at a significant cost to the institution.
Watson
D R
DR
Riverside Methodist Hospitals, Columbus, OH, USA.
Duff
S B
SB
D000368:Aged; D002408:Catheters, Indwelling / Q000191:economics; D001026:Coronary Artery Bypass / Q000191:economics* / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D012680:Sensitivity and Specificity; D013906:Thoracoscopy / Q000191:economics / Q000379:methods*; D013908:Thoracotomy / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome