Sutureless Valves Reduce Hospital Costs Compared to Traditional Valves

摘要

Background and aim of the study: The study aim was to assess differences in clinical outcome, safety, and associated costs between sutureless and aortic isolated aortic valve replacement (AVR) with a standard bioprosthesis. Methods: A retrospective comparative study was conducted to investigate 65 patients, each of whom had undergone isolated AVR with a traditional aortic valve (T) or a Perceval S sutureless aortic prosthesis (P) between January 2010 and December 2012. Cost data were drawn from the proprietary cost accounting system of the hospital, excluding acquisition costs of the devices. A linear regression model was used to estimate the mean total costs difference between groups. Results: The mean cardiopulmonary bypass time and aortic cross-clamp times in the T and P groups were 80 ± 41 min and 58 ± 26 min versus 38 ± 16 min and 26 ± 10 min, respectively (p <0.0001). The mean intensive care unit and ward stays in both groups were 4.2 ± 5.9 and 11.9 ± 6.5 days versus 3.8 ± 4.7 and 10 ± 4.5 days, respectively (p = 0.68 and p = 0.05). The mean costs savings for group P compared to group T were €3,801 (p = 0.13), mainly driven by hospital stay costs. Savings between the P and T groups increased with age: €4,992 in patients aged 70-79 years and €9,326 in those aged 80+ years, and with risk (€4,296 for high-risk patients). Conclusion: Sutureless aortic valves present shorter procedural times and lower hospital costs compared to traditional valves, with higher cost savings at increased patient age and risk. Sutureless aortic valves seem to be cost-effective in patients undergoing AVR.