Gs. Couper et al., The logistics and cost-effectiveness of circulatory support: Advantages ofthe ABIOMED BVS 5000, ANN THORAC, 68(2), 1999, pp. 646-649
Citations number
16
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. In 1994 the ABIOMED BVS 5000 was incorporated into our acute ca
rdiac assist armamentarium. This report is a general overview of our experi
ence. A hypothetical cost analysis focusing on specific devices and device-
related personnel contrasted the BVS 5000 with our prior model of centrifug
al pump use.
Methods. In 3 years, 22 patients were supported with the BVS 5000, as a biv
entricular assist device in 40%, right ventricular assist device in 27%, an
d left ventricular assist device in 32%. Indications were postcardiotomy su
pport in 12, acute myocarditis in 2, bridge to transplant in 4, and failed
heart transplant in 4. The cost analysis was performed retrospectively. The
actual cost of disposable blood pumps, including replacement pumps, and ca
nnulae constituted the BVS cost. The hypothetical centrifugal costs include
d the disposables, replacement cones, as well as the labor costs of the con
tinuous perfusionist coverage.
Results. Of the 22 patients, 10 (45%) were weaned and 13 (59%) were success
fully discharged. Five patients were transplanted while on BVS 5000 support
, accounting for a higher rate of discharge. Comparison of "actual" BVS cos
ts with "projected" centrifugal costs revealed differences based upon the i
ntended application of the BVS. In bridge-to-transplant patients with long
duration of support, the daily cost of support was dramatically lower with
the BVS 5000. For short-term postcardiotomy support, acute myocarditis, or
failed transplant, the differences were small.
Conclusions. Because the BVS 5000 was readily managed by the intensive care
unit nursing staff, this system displaced centrifugal systems in our progr
am. Outcome measures of weaning and successful discharge were improved rela
tive to our prior experience with centrifugal pumps. Even without taking in
direct costs into account, the hypothetical cost analysis supported continu
ed use of the BVS system for acute cardiac assistance. (C) 1999 by The Soci
ety of Thoracic Surgeons.