Does Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass Reduce Costs in Cardiac Surgery?
E Hijazi. Does Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass Reduce Costs in Cardiac Surgery?. The Internet Journal of Thoracic and Cardiovascular Surgery. 2009 Volume 14 Number 2.
Technical improvements in coronary revascularization over the past decade have led to a revival of interest in off-pump coronary artery bypass surgery. Cost containment in coronary artery bypass surgery is becoming increasingly important in modern hospital management. Therefore, further savings could be obtained by using a surgical technique able to decrease the fixed direct cost while maintaining clinical quality of care. Economic considerations are an extremely important issue in evaluating the role of off-pump coronary artery bypass grafting in the future of cardiac surgery, as off-pump coronary artery bypass grafting is expected to lower costs by reducing perioperative morbidity and recovery time. However, the acceptance of this procedure as a routine alternative for the treatment of coronary artery disease will depend on both long-term graft patency rates as well as a competitive market cost. This review examines these effects.
Kolessov (1) reported the first experience with coronary artery surgery on the beating heart in 1967, but the technique was soon abandoned with the advent of cardiopulmonary bypass (CPB). However, off-pump coronary artery bypass grafting (OPCAB) has experienced a revival, beginning in the early 1990s with the work of Benetti et al (2) and Buffolo et al. (3). Their work in South America was motivated by economic considerations but demonstrated that unexpected benefits were associated with the avoidance of CPB and these includes much lower morbidity in high risk patients, aged 70 or older, the ischemia produced during this procedure is well tolerated independently from the coronary anatomy and the patient’s clinical picture. They have had maintenance
We used MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Science Citation Index (SCI), Current Contents, NHS Economic Evaluation Database (NEED), and International Network of Agencies for Health Technology Assessment (INAHTA) databases were searched from the date of their inception to the end of December 2007, using the search terms off-pump bypass surgery, beating heart,
The length of hospital stay and the incidence of death after CABG is a function of multiple variables primarily related to a patient's premorbid condition and the morbidity associated with the procedure. By reducing the morbidity rates associated with the procedure and decreasing the incidence of complications, the use of OPCAB has decreased the length of hospital stay and cost savings (13)
The present review demonstrates the safety and efficacy of OPCAB surgery.