Cost-Benefit Analysis of Robotic Versus Nonrobotic Minimally Invasive Mitral Valve Surgery. Issue 2 (March 2015)

• Record Type: Journal Article
• Authors: Hassan, Mohammed; Miao, Yongjie; Lincoln, Joy; Ricci, Marco
• Is Part Of: Innovations. Volume 10:Issue 2(2015:Mar./Apr.)
• Publication Date: 2015-03
• Subjects: Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1097/IMI.0000000000000136
• Languages: English
• ISSNs: 1556-9845

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>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.</p> </sec> <sec> <title>Methods</title> <p>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.</p> </sec> <sec> <title>Results</title> <p>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; <italic>P</italic> = 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; <italic>P</italic> < 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; <italic>P</italic> = 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, <italic>P</italic> < 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).</p> </sec> <sec> <title>Conclusions</title> <p>Our comparative analysis provides insights into the clinical benefits versus variable costs relationship related to mini-MVR and robotic MVR.</p> </sec> </abstract>