2004, Number 4
<< Back Next >>
Arch Cardiol Mex 2004; 74 (4)
Treatment of patent ductus arteriosus. Comparison of costs between surgical and transcatheter closures in a public institution
Vázquez-Antona CA, Vallejo M, Becerra BR, González A, Buendía HA, Vargas BJ
Language: Spanish
References: 18
Page: 276-282
PDF size: 71.13 Kb.
ABSTRACT
The costs of transcatheter closure of patent ductus arteriosus in relation to the surgical closure still a controvertial issue in our hospitals. The aim of the study was compared the costs of both treatments.
Methods: We included 57 patients treated with transcatheter occlusion and 26 underwent surgery. Information about laboratory tests, average in hospital days of stay, anesthesia type and duration, operating and hemodinamic room costs, was gather. A database containing the costs from the institution unitary costs system in force was designed.
Results: sociodemographyc characteristics were similar in both groups. Ductus size was larger in patients treated with surgery (p<0.05). In hospital stay, as well as, the number of complications after the procedure were less in the patients treated with transcatheter occlusion (p<0.05). The closure with Amplatzer® device was more expensive than the surgical one, and both were more expensive than coil. With surgical treatment, 86.5% of the costs are due to in hospital stay, with the Amplatzer® this issues represented a 36%, however, the cost of the devices by itself represents a 40% of the total treatment cost.
Conclusions: Even though total charges of Amplatzer® devices are more expensive than surgery, transcatheter occlusion represents advantages in relation to less in hospital stay, resources used and number of complications, which allows hospital resources optimization.
REFERENCES
Attie F: Cardiopatías congénitas. Morfología, cuadro clínico y diagnóstico. México Salvat Ed. 1985; pág 151.
Thilen U, Astrom-Olsson K: Does the risk of infective endocarditis justify routine patent ductus arteriosus closure? Eur Heart J 1997; 18: 503-506.
Huggon IC, Qureshi SA: Is the prevention of infective endocarditis a valid rason for closure of the patent arterial duct? Eur Heart J 1997; 18: 364-366.
Wolpert E, Yánez Clavel RM, Treviño N, Villalpando F, Varela CE: Modelo de Intervención de trabajo social de los Institutos Nacionales de Salud. Coordinación de Institutos Nacionales de Salud. Secretaría de Salud 1999.
Danford DA: Cost-effectiveness of echocardiography for evaluation of children with murmurs. Echocardiography 1995; 12(2): 153-62.
Quijano-Pitman F: La cirugía del conducto arterioso. México Fomento Cultural Banamex AC 1976.
Mavroudis C, Backer CL, Gevitz M: Forty–six years of patent ductus arteriosus division at Children´s Memorial Hospital of Chicago: standards for comparison. Ann Surg 1994; 220: 402-410.
Vázquez-Antona CA, Rijlaarsdam M, Gaspar J, Gil M, Buendía A: Cierre de conducto arterioso persistente transcateterismo. Experiencia inicial. Arch Inst Cardiol Mex 1993; 63: 493-499.
Chessa M, Mohamed B, Giusti S, Butera G, Bini RM, Carano N, et al: Transcatheter treatment of patent ductus arteriosus. Ital Heart J 2002; 3(11Supp): 1092-7.
Bubul ZR, Fahey JT, Doyle TP, Hijazi ZM, Hellenbrand WE: Transcatheter closure of the patent ductus arteriosus: a comparative study between occluding coils and the Rashkind Umbrella Device. Cathet Cardiovasc Diagn 1996; 39: 335-363.
Gray DT, Fyler DC, Walker AM, Weinstein MC, Chalmers TC: Clinical outcomes and costs of transcatheter as compared with surgical closure of patent ductus arterious. N Engl J Med 1993; 329: 1517-23.
Prieto LR, DeCamillo DM Konrad DJ, Scalet-Longworth L, Latson LA: Comparison of cost and clinical outcome between transcatheter coil occlusion and surgical closure of isolated patent ductus arteriosus. Pediatrics 1998; 101: 1020-1024.
Hawkins JA, Minich LL, Tani LY, Sturtevant JE, Orsmond GS, McGough EC: Cost and efficacy of surgical ligation versus transcatether coil occlusion of patent ductus arteriosus. J Thorac Cardiovasc Surg 1996; 112(6): 1638-9.
Singh TP, Morrow R, Walters HL, Vitale NA, Hakimi M: Coil occlusion versus conventional surgical closure of patent ductus arteriosus. Am J Cardiol 1997; 79: 1283-5.
Faella HJ, Hijazi ZM: Closure of the patent ductus arteriosus with the Amplatzer PDA Device: Immediate results of the international trial. Cath Cardiovasc Intervent 2000; 51: 50-54.
Bilkis A, Alwi M, Hasri S, Haifa A, Geetha K, Rehman M, Hasanah I: The Amplatzer Duct Occluder: Experience in 209 patients. J Am Coll Cardiol 2001; 37: 258-61.
Sorensen KE, Kristensen BO, Hansen OK: Frequency of occurrence of residual ductal flow after surgical ligation by color-flow mapping. Am J Cardiol 1991; 67: 653-654.
Trippestad A, Efskind L: Patent ductus arteriosus, surgical treatment of 686 patients. Scand J Thorac Cardiovasc Surg 1972; 6: 38-42.