Economic impact of mitral valve plasty versus replacement for mitral valve insufficiency.
OBJECTIVE
The principal techniques for surgical correction of mitral valve regurgitation (MR) were compared, with emphasis on the economic impact.


METHODS
In a prospective non-randomized study 225 patients undergoing mitral valve repair were analyzed, 75 had mitral valve plasty (MVP) and 150 had mitral valve replacement (MVR). Patient demographics showed no group differences.


RESULTS
Cardiopulmonary bypass time and ischemia time were shorter in the MVP-group, p<0.0001. Hospital mortality was lower after MVP, 2.0% (3/150) compared to MVR, 6.7% (5/75). ICU-stay was shorter in the MVP-group and so was length of postoperative hospital stay, p=0.014. Urgent operation was the only significant risk factor for mortality after MVP. Re-operation, endocarditis, grade IV MR, and NYHA class IV were additional risk factors in the MVR-group. Postoperative improvements of NYHA and mitral valve function were similar in both groups. MVP was more cost effective than MVR (18,050 USD or 20,430 Euro versus 24,824 USD or 28,097 Euro, p<0.001).


CONCLUSIONS
Mitral valve plasty for MR is efficient and associated with shorter CPB and ischemia times as well as length of stay in ICU, together with a lower device cost, which makes MVP more cost effective than MVR.
Christenson
J T
JT
Clinic for Cardiovascular Surgery, University Hospital, Geneva, Switzerland. JTChristenson@hotmail.com
Kalangos
A
A
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000191:economics / Q000601:surgery*; D011446:Prospective Studies; D013557:Switzerland