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A Cost-Effectiveness Comparison of Surgical Treatments for Mitral Valve Disease

Published online by Cambridge University Press:  10 March 2009

Basil N. Papageorge  and
Stuart O. Schweitzer
Basil N. Papageorge
Affiliation:
University of California, Los Angeles
Stuart O. Schweitzer
Affiliation:
University of California, Los Angeles
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Abstract

This study compares the cost-effectiveness of mitral valve reconstruction and replacement. Published clinical data were used to determine the effectiveness of each procedure. Both direct and indirect costs were calculated. The findings indicate that reconstruction has lower costs per year of life extended than replacement due to better outcomes. Changing outcome probabilities and discount rates did not alter these results. Cost savings in excess of 40% may be achieved by early reconstruction for suitable patients. These results suggest that the prevailing practice of delaying surgery until replacement is needed should be reconsidered, especially for patients who could benefit from reconstruction.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 4 , Issue 3 , July 1988 , pp. 447 - 461
Copyright
Copyright © Cambridge University Press 1988

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References

REFERENCES

1.Burch, G. E., & Giles, T. D.Clinical evaluation of aortic and mitral valve prostheses. American Heart Journal 1976, 92, 245.CrossRefGoogle ScholarPubMed
2.Burr, L. H., Krayenbuhl, C., Sutton, M. B. J., et al. Mitral plication suture. Journal of Thoracic and Cardiovascular Surgery, 1977, 73, 589.CrossRefGoogle ScholarPubMed
3.Carpentier, A., Chauvaud, S., et al. . Reconstructive surgery for mitral valve incompetence: Ten-year appraisal. Journal of Thoracic and Cardiovascular Surgery, 1980, 79, 338–48.CrossRefGoogle ScholarPubMed
4.Duran, C. G., Poma, J. L., et al. Conservative operation for mitral insufficiency. Journal of Thoracic and Cardiovascular Surgery, 1980, 79, 326–37.CrossRefGoogle ScholarPubMed
5.Gross, R. L., Cunningham, J. N., et al. Long-term results of open radical mitral commissurotomy: Ten year follow-up study of 202 patients. American Journal of Cardiology, 1981, 47, 821–25.CrossRefGoogle ScholarPubMed
6.Hochberg, M. S., Derkac, W. M., et al. Mitral valve replacement in elderly patients: Encouraging post operative clinical and hemodynamic results. Journal of Thoracic and Cardiovascular Surgery, 1979, 77, 423.CrossRefGoogle Scholar
7.Kay, J. H., Zuklate, P., Mendez, M. A., et al. Mitral valve repair for patients with pure mitral valve insufficiency. Journal of the American Medical Association, 1976, 236, 1584.CrossRefGoogle Scholar
8.Kirklin, J. W., & Pacifico, A. D.Surgery for acquired valvular heart disease. New England Journal of Medicine, 1973, 288, 197CrossRefGoogle ScholarPubMed
9.Laschinger, J. C., Cunningham, J. N., et al. Early radical commissurotomy surgical treatment of choice for mitral stenosis. Annals of Thoracic Surgery, 1982, 34, 287–98.CrossRefGoogle ScholarPubMed
10.Nunley, D. L., & Starr, A.The evolution of reparative techniques for the mitral valve. Annals of Thoracic Surgery, 1984, 37, 393–97.CrossRefGoogle ScholarPubMed
11.Oury, J. H., Peterson, K. L., Folkerth, T. L., et al. Mitral valve replacement versus reconstruction: An analysis of indications and results of Mitral Valve procedure in a consecutive series of 80 patients. Journal of Thoracic and Cardiovascular Surgery, 1977, 73, 825.CrossRefGoogle Scholar
12.Peterson, K. L.The timing of surgical intervention in chronic mitral regurgitation. Catheterization and Cardiovascular Diagnosis, 1983, 9, 433–38.CrossRefGoogle ScholarPubMed
13.Portal, R. W.Mitral stenosis: The picture changes. British Medical Journal, 1984, 288, 167–68.CrossRefGoogle ScholarPubMed
14.Rapaport, E.Natural history of aortic and mitral valve disease. American Journal of Cardiology, 1972, 35, 221.CrossRefGoogle Scholar
15.Schuler, G., Peterson, K. L., et al. Temporal response of left ventricular performance to mitral valve surgery. Circulation, 1979, 59, 1218–31.CrossRefGoogle ScholarPubMed
16.Selzer, A., & Katayama, FMitral regurgitation: Clinical patterns, pathophysiology and natural history. Medicine (Baltimore), 1972, 51, 337.CrossRefGoogle ScholarPubMed
17.Spencer, F C.A plea for early open mitral commissurotomy. American Heart Journal, 1978, 95, 668–70.CrossRefGoogle ScholarPubMed
18.U.S. Department of Commerce. Statistical Abstract 1979. Washington, D C: U.S. Government Printing Office, 1979, 419.Google Scholar