The clinical and financial impact of port-access coronary revascularization

Objective: Port-access coronary bypass grafting (CABG)was performed in an a ttempt to impact the clinical course of patients with coronary artery disea se. Methods: One hundred patients (56 men and 44 women) with a median age o f 61 years underwent port-access coronary revascularization. The clinical a nd financial profiles of these patients were compared with fiscal year 1997 patients (n = 531) who underwent standard median sternotomy coronary bypas s. Results: Preoperative clinical demographics were similar in both groups of patients. Among the pea-access population there were no incidences of ao rtic dissection, deep vein thrombosis, conversion to median sternotomy, or death. Total time in the Intensive Care Unit (ICU), incidence of atrial fib rillation, transfusion requirements, and (subjective) pain rating at 28 day s postoperatively were less in the pea-access group. The average hospital c ost per case was $2703.00 (US dollars) more in the port-access patients, de spite a similar length of stay versus conventional sternotomy patients. Con clusions: Coronary bypass surgery can be performed safely with port-access technology with significant clinical benefits in selected patients. Current ly these benefits are attained at a significant cost to the institution. (C ) 1999 Elsevier Science B.V. All rights reserved.