Economic evaluation of different minimally invasive procedures for the treatment of coronary artery disease.
OBJECTIVE
Several different techniques exist within the field of minimally invasive coronary artery surgery. In this study the impact of all these techniques on the total costs and economics has been evaluated.


METHODS
Since May 1997, 121 minimally invasive direct coronary artery bypass (MIDCAB) procedures, 125 off-pump coronary artery bypass (OPCAB), ten Port-Access coronary artery bypass (PA-CABG) and 10 endoscopic coronary artery bypass grafting (ENDO-CABG) procedures were performed at our institution. A relative cost analysis of the different procedures was carried out in addition to a thorough evaluation done in five patients of each group dividing the costs into staff-related costs, material-related costs and general hospital costs. The costs were set in relation to regular CABG procedures.


RESULTS
Specific less invasive coronary artery surgical techniques, such as the MIDCAB or OPCAB technique already are able to reduce the total costs when compared to regular CABG procedures. Within the Port-Access group as well as the ENDO-CABG group, increased material- and general costs are present when compared to regular CABG leading to increased total hospital costs for PA-CABG and Endo-CABG in Germany.


CONCLUSIONS
At present, MIDCAB and OPCAB procedures are able to reduce total hospital charges, when compared to regular CABG procedures. Increased costs for Port-Access, as well as Endo-CABG surgeries may be compensated in the future by decreased costs due to a shorter phase of rehabilitation and faster return to regular professional activities.
Reichenspurner
H
H
Department of Cardiac Surgery, University Hospital Grosshadern, Munich, Germany. hcr@hch.med.uni-muenchen.de
Boehm
D
D
Detter
C
C
Schiller
W
W
Reichart
B
B
D017546:Angioscopy / Q000191:economics; D001026:Coronary Artery Bypass / Q000191:economics* / Q000379:methods; D003325:Coronary Care Units / Q000191:economics; D003327:Coronary Disease / Q000191:economics* / Q000601:surgery*; D003365:Costs and Cost Analysis; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000191:economics*; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000191:economics / Q000379:methods