Cost-benefit analysis of robotic versus nonrobotic minimally invasive mitral valve surgery. Innovations (Phila) 2015;10(2):90-5
Date
03/27/2015Pubmed ID
25811708DOI
10.1097/IMI.0000000000000136Scopus ID
2-s2.0-84930349723 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
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 MAuthor
Joy Lincoln PhD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cardiopulmonary BypassCost-Benefit Analysis
Female
Heart Valve Diseases
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures
Mitral Valve
Robotic Surgical Procedures