Skip Navigation


European Heart Journal Advance Access originally published online on April 8, 2005
European Heart Journal 2005 26(10):1046; doi:10.1093/eurheartj/ehi239
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
26/10/1046    most recent
ehi239v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Kastanioti, C. K.
Right arrow Articles by Goudevenos, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kastanioti, C. K.
Right arrow Articles by Goudevenos, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Cost-effectiveness of on-pump and off-pump bypass surgery

Catherine K. Kastanioti

Division of Economics
University Hospital of Ioannina
45110 Ioannina
Greece
Tel: +30 265 1097227
Fax: +30 265 1097017
E-mail address: catherinekastanioti{at}yahoo.gr

Theofilos M. Kolettis

Department of Cardiology
University of Ioannina
45110 Ioannina
Greece

George Stavridis

Onassis Cardiac Surgery Centre
17674 Athens
Greece

John Goudevenos

Department of Cardiology
University of Ioannina
45110 Ioannina
Greece

We read with great interest the comprehensive review by Murphy et al.1 This review of the published literature critically examines the potential benefits of off-pump coronary artery bypass surgery (OPCAB) compared with conventional coronary artery bypass grafting (CABG). A number of important endpoints were examined, such as inflammatory and cellular responses. Their impact on organ dysfunctions was studied, namely myocardial, renal and neurological injuries. Clinical trials, carefully reviewed by Murphy et al.1 have collectively indicated lower morbidity in patients undergoing OPCAB, compared with CABG, with equivalent mid-term outcome.

In addition, comparison of the cost-effectiveness of the two surgical techniques suggests significantly increased direct costs in patients undergoing CABG, compared with OPCAB, with a comparable increase in quality-adjusted years of life.2,3 Our group has previously reported on 102 patients undergoing either CABG or OPCAB.4 In keeping with previous results,2,3 we found that OPCAB was associated with a total reduction in direct and, importantly, non-direct (non-patient related) costs of 3.357{euro} per patient, compared with CABG. As in previous studies, this difference was due to significantly fewer post-operative complications and shorter hospital stay.

We feel that in the era of significant economic constraints, coupled with continuously escalating medical costs, analyses on cost-effectiveness ratios of various interventions become essential not only for medical practitioners, but also for governments and health-care policymakers.

References

  1. Murphy GJ, Ascione R, Angelini GD. Coronary artery bypass grafting on the beating heart: surgical revascularization for the next decade? Eur Heart J 2004;25:2077–2085.[Abstract/Free Full Text]
  2. Nathoe HM, van Dijk D, Jansen EW et al. A comparison of on pump and off pump coronary bypass surgery in low-risk patients. N Engl J Med 2003;348:395–402.
  3. Puskas JD, Williams WH, Mahoney EM et al. Off-pump vs. conventional coronary bypassgrafting: early and 1-year graft patency, cost and quality-of-lie outcomes: a randomized trial. JAMA 2004;291:1841–1849.[Abstract/Free Full Text]
  4. Kastanioti KK, Kioulafas K, Baltopoulos G et al. Cost-effectiveness analysis: a comparison between on pump and off pump coronary bypass surgery. Int J Qual Life Res 2004;2:190–195.

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
J. Bergsland, E. Kabil, E. Mujanovic, I. Terzic, J. Roislien, J. L. Svennevig, and E. Fosse
Training of Cardiac Surgeons for Bosnia and Herzegovina: Outcomes in Coronary Bypass Grafting Surgery
Ann. Thorac. Surg., February 1, 2007; 83(2): 462 - 467.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
26/10/1046    most recent
ehi239v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Kastanioti, C. K.
Right arrow Articles by Goudevenos, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kastanioti, C. K.
Right arrow Articles by Goudevenos, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?