Breakthrough Study Quantifies Faster Recovery and Cost Savings with Port-Access Minimally Invasive Heart Valve Surgery
NEW ORLEANS, LA - New data presented by NYU Medical Center surgeons at the annual meeting of the American College of Cardiology substantiate claims of shortened hospitalization, reduced complication risk and significant cost savings associated with port-access minimally invasive heart valve surgery (PA). The large study also answers questions raised by previous studies by matching patients in the PA group to those undergoing traditional open-chest surgery for relevant variables affecting these findings.
Results of this study demonstrated that the PA patients left the hospital an average of four days earlier than their open-chest counterparts, needed 12% fewer blood (including autologous) transfusions and were six times less likely to have septic or wound infections. Attributable to these findings, and other factors such as age and history, was a substantial savings in total hospital costs, an average $2,000 less for PA cases, despite up-front costs for the technology.
Data were prospectively gathered on all 109 patients undergoing port-access minimally invasive isolated valve surgery at NYU Medical Center and a case-match analysis was performed to compare their outcomes with 88 patients who had undergone isolated valve surgery using a median sternotomy approach in the previous year. The PA group was matched with controls by age, surgeon, congestive heart failure status, valve position, and history of previous surgery.
"There were questions about some of our initial research, suggesting that we selected healthier, lower risk patients for our port-access cases," said Eugene A. Grossi, M.D., associate professor of surgery at the NYU School of Medicine, lead author and presenter of the study. "This is a much larger study which offers more specific information about the groups compared and validates our initial predictions of utility for virtually all patients with valvular heart disease."
The statistical significance of this study demonstrates the advantages of a less painful, less traumatic approach to heart valve surgery and includes the earliest experience with the technique at NYU Medical Center. Overall experience since the first patient was treated with a port-access approach in May 1996 has raised expectations for patient outcomes, recovery and quality of life and has changed clinical pathways for nearly 1,000 minimally invasive cardiac surgical patients. Currently, and for the past 18 months, patients undergoing port-access valve and bypass surgery move much more quickly through their post-operative care, often leaving the hospital within three to five days. "The remarkable success of patients in our fast track care map reflects the tremendous impact that port-access minimally invasive techniques have had on their recovery and return to normal functioning," said Stephen B. Colvin, M.D., chief of cardiothoracic surgery and senior author of the study. "We have emerging data that shows these patients returning to normal daily functioning in a fraction of the time that they would be able to if they had open-chest surgery. Many are going back to full-time work in three or four weeks." NYU Medical Center's Department of Cardiothoracic Surgery is internationally recognized for mitral valve reconstructive surgery and, more recently, for expertise in the early development and practice of minimally invasive surgical techniques in adults and children. NYU surgeons were instrumental in the clinical development of port-access technology and have done more cases using this approach than any other surgeons worldwide.
NEW ORLEANS, LA - New data presented by NYU Medical Center surgeons at the annual meeting of the American College of Cardiology substantiate claims of shortened hospitalization, reduced complication risk and significant cost savings associated with port-access minimally invasive heart valve surgery (PA). The large study also answers questions raised by previous studies by matching patients in the PA group to those undergoing traditional open-chest surgery for relevant variables affecting these findings.
Results of this study demonstrated that the PA patients left the hospital an average of four days earlier than their open-chest counterparts, needed 12% fewer blood (including autologous) transfusions and were six times less likely to have septic or wound infections. Attributable to these findings, and other factors such as age and history, was a substantial savings in total hospital costs, an average $2,000 less for PA cases, despite up-front costs for the technology.
Data were prospectively gathered on all 109 patients undergoing port-access minimally invasive isolated valve surgery at NYU Medical Center and a case-match analysis was performed to compare their outcomes with 88 patients who had undergone isolated valve surgery using a median sternotomy approach in the previous year. The PA group was matched with controls by age, surgeon, congestive heart failure status, valve position, and history of previous surgery.
"There were questions about some of our initial research, suggesting that we selected healthier, lower risk patients for our port-access cases," said Eugene A. Grossi, M.D., associate professor of surgery at the NYU School of Medicine, lead author and presenter of the study. "This is a much larger study which offers more specific information about the groups compared and validates our initial predictions of utility for virtually all patients with valvular heart disease."
The statistical significance of this study demonstrates the advantages of a less painful, less traumatic approach to heart valve surgery and includes the earliest experience with the technique at NYU Medical Center. Overall experience since the first patient was treated with a port-access approach in May 1996 has raised expectations for patient outcomes, recovery and quality of life and has changed clinical pathways for nearly 1,000 minimally invasive cardiac surgical patients. Currently, and for the past 18 months, patients undergoing port-access valve and bypass surgery move much more quickly through their post-operative care, often leaving the hospital within three to five days. "The remarkable success of patients in our fast track care map reflects the tremendous impact that port-access minimally invasive techniques have had on their recovery and return to normal functioning," said Stephen B. Colvin, M.D., chief of cardiothoracic surgery and senior author of the study. "We have emerging data that shows these patients returning to normal daily functioning in a fraction of the time that they would be able to if they had open-chest surgery. Many are going back to full-time work in three or four weeks." NYU Medical Center's Department of Cardiothoracic Surgery is internationally recognized for mitral valve reconstructive surgery and, more recently, for expertise in the early development and practice of minimally invasive surgical techniques in adults and children. NYU surgeons were instrumental in the clinical development of port-access technology and have done more cases using this approach than any other surgeons worldwide.