TECHNOLOGY-ASSESSMENT OF NONSURGICAL CLOSURE OF PATENT DUCTUS-ARTERIOSUS - AN EVALUATION OF THE CLINICAL EFFECTIVENESS AND COSTS OF A NEW MEDICAL DEVICE

Objective. To assess the clinical efficacy and cost impact of a new me dical device for the nonsurgical closure of patent ductus arteriosus ( PDA). Methods. This was a before-after study comparing the most recent 20 surgical procedures with the first 20 nonsurgical procedures for P DA using a new medical device. Clinical outcome, hospital stay, device test, and physician fees were compared. Results. Surgical closure was effective in all 20 patients, with an average cost of $4667. In a sim ilar patient group, nonsurgical closure was achieved in 18 of 20 patie nts (90%), with an estimated average cost per successful procedure of $4690. A clinically insignificant PDA leak persisted beyond 12 months in four nonsurgically managed patients. Conclusion. Nonsurgical closur e of PDA can be recommended as an effective new medical technique that is not associated with a measurable increase in direct costs and that provides significant indirect and intangible cost advantages.