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Fast-Track/Off Pump/Prediction/Outcome

Is off-pump coronary artery bypass grafting (OPCABG) more cost-effective than the on-pump procedure?: 044

Hofer, C. K.; Tavakoli, R.1; Maloigne, M.; Turina, M.1; Zollinger, A.; Genoni, M.1

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European Journal of Anaesthesiology: June 2004 - Volume 21 - Issue - p 22

Introduction: Patients undergoing OPCABG benefit in terms of postoperative recovery, myocardial ischaemia and blood transfusion requirements [1,2]. The aim of this investigation was to compare the expenses for OPCABG and the conventional on-pump CABG (ONPUMP) procedures.

Method: Cost calculation was performed using a model of a standard patient undergoing CABG with four anastomoses and data (mean values) derived from a prospective database of a one-year period. Intraoperative routine costs (operative material and anaesthesia), expenses for transfusion requirements, intensive care unit (ICU) and hospital stay were evaluated. Costs for human resources, local facilities (i.e. OR utilization) and expenses for interventions deviating from the routine procedure were not considered.

Results: 255 OPCABG and 24 ONPUMP were performed from 01/2002-12/2002.

Table
Table:
Table. Summary of costs.

Discussion: The present cost calculation model for CABG procedures demonstrates that OPCABG operations may actually be more cost-effective than conventional on-pump CABG interventions.

References:

1 Ngaage DL. Off-pump coronary artery bypass grafting: the myth, the logic and the science. Eur J Cardiothorac Surg 2003; 24: 557-570.
2 Biocina B, Sutlic Z, Rudez I, et al. Multiple arterial off-pump coronary artery bypass grafting: a 5-year experience with clinical results. Heart Surg Forum 2003; 6: 132-134.
© 2004 European Society of Anaesthesiology