Transcatheter aortic valve implantation versus sutureless aortic valve replacement: a single-centre cost analysis.
Acta Cardiol
; 79(1): 30-40, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37882608
ABSTRACT
AIMS:
Sutureless aortic valve replacement (SU-AVR) and transcatheter aortic valve implantation (TAVI) are both viable therapeutic interventions for aortic stenosis in elderly patients. Meta-analyses show similar all-cause mortality for both techniques albeit with a different pattern of adverse effects. This study means to compare costs and, to a lesser extent, clinical outcomes of both techniques.METHODS:
A retrospective single-centre analysis was performed for patients receiving SU-AVR or TAVI from 2008 to 2019. Perioperative clinical data were collected from patient files. Costs were assessed by a cost allocation tool. In an attempt to avoid confounding, propensity score matching was carried out.RESULTS:
A total of 368 patients underwent either TAVI (n = 100) or SU-AVR (n = 268). After matching, there were 61 patients per treatment group. Length of stay was significantly longer in the SU-AVR group. Excluding device costs, total expenses for SU-AVR (median 11,630) were significantly higher than TAVI (median 9240). For both groups, these costs were mostly incurred on intensive care units, followed by nursing units. Non-medical staff was the largest contributor to expenses. Including device costs, SU-AVR (median 14,683) was shown to be cost-saving compared to TAVI (median 24,057).CONCLUSIONS:
To conclude, we found SU-AVR to be cost-saving compared to TAVI, largely due to higher device costs associated with the latter. Excluding device costs, TAVI was associated with lower expenses and shorter length of stay. Non-medical staff was the largest source of costs, suggesting length of stay to be a major financial determinant.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
/
Substituição da Valva Aórtica Transcateter
Limite:
Aged
/
Humans
Idioma:
En
Revista:
Acta Cardiol
Ano de publicação:
2024
Tipo de documento:
Article