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Cost-benefit analysis of robotic versus nonrobotic minimally invasive mitral valve surgery. Innovations (Phila) 2015;10(2):90-5

Date

03/27/2015

Pubmed ID

25811708

DOI

10.1097/IMI.0000000000000136

Scopus ID

2-s2.0-84930349723 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

OBJECTIVE: To date, a direct comparison of minimally invasive mitral valve repair or replacement (mini-MVR) versus robotic MVR is lacking; therefore, the purpose of this study was to address this deficit and compare mini-MVR with robotic MVR from a cost-benefit perspective.

METHODS: From a total of 759 literature citations, 21 studies were included for statistical comparisons of benefit outcomes, whereas 3 studies and our institutional experience were used to compare costs.

RESULTS: The total cost per case exceeding that of conventional MVR is approximately $2063.90 for robotic MVR and $271 for mini-MVR. Mean 30-day mortality rates for mini-MVR and robotic MVR groups were 1.24% and 0.55%, respectively [106/8548 vs 6/1089; odds ratio (OR), 2.27; P = 0.052]. The conversion rate to conventional MVR was 0.77% in mini-MVR and 1.83% in robotic MVR (35/5092 vs 22/1046; OR, 0.32; P < 0.001). The rate of neurologic events was 1.32% in mini-MVR and 2.37% in robotic MVR (109/8257 vs 20/845; OR, 0.55; P = 0.02). Postoperative atrial fibrillation was seen in 11.42% of mini-MVR patients and in 19.67% of robotic MVR patients (371/3249 vs 203/1032; OR, 0.53, P < 0.001). Mean cardiopulmonary bypass time was longer in mini-MVR (137.4 vs 130.4 minutes), whereas cross-clamp time was shorter (82.2 vs 96.7 minutes).

CONCLUSIONS: Our comparative analysis provides insights into the clinical benefits versus variable costs relationship related to mini-MVR and robotic MVR.

Author List

Hassan M, Miao Y, Lincoln J, Ricci M

Author

Joy Lincoln PhD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cardiopulmonary Bypass
Cost-Benefit Analysis
Female
Heart Valve Diseases
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures
Mitral Valve
Robotic Surgical Procedures