Analysis of cost and clinical results of coronary artery bypass grafting on the beating heart

Akinci E., BOZBUĞA N., Daglar B., Balkanay M., Ogus N., Isik O., ...More

Cor Europaeum - European Journal of Cardiac Interventions, vol.8, no.2, pp.62-65, 1999 (Scopus) identifier


Coronary artery bypass grafting (CABG) operation on the heating heart (BH) without cardiopulmonary bypass (CPB) procedure is associated with a significant reduction in resource utilization and morbidity related to initial hospitalization compared with conventional CABG. From 1993 to 1996, 428 consecutive patients underwent CABG on BH, since their coronary artery lesions included left anterior descending (LAD) and/or right coronary artery (RCA) thus enabling complete revascularization on BH. All patients had no additional risk factors for CABG procedure (Group I). This group of patients' outcomes and costs were compared with those of a matched (regarding age, gender, the number of grafts, left ventricular function and date of operation) control group of 100 patients operated on CABG with CPB (Group II) retrospectively. No significant differences were observed in the two groups for preoperative variables known to affect cost and resource utilization. We found no statistically significant difference between groups in mortality (BH, 0.9%; CABG 1.0%). The length of stay in ICU was 1.8 ± 0.3 days for BH compared to 2.1 ± 1.2 days for CABG (p < 0.05); the length of stay in hospital was 5.8 ± 2.2 days for BH group and 8.3 ± 1.8 days for CABG (p < 0.01). It was calculated that the CABG on BH group cost was 50% less than that of the CPB group. There was a total cost saving in hospitalization, medication operation of 1367$ per case in comparison with conventional CABG with ECC. Our experience showed that CABG procedure on the beating heart can be performed with a low perioperative mortality rate, satisfactory outcome, short hospitalization, at low cost and with improved patient comfort.