Surgical ventricular restoration versus cardiac transplantation: a comparison of cost, outcomes, and survival

Journal of Cardiac Failure
Jason A WilliamsJohn V Conte

Abstract

Cardiac transplantation is the accepted standard treatment for end-stage heart disease but is donor limited. Surgical ventricular remodeling is an established treatment for patients with ischemic cardiomyopathy. We sought to compare charges, outcomes, and survival in patients undergoing surgical ventricular restoration (SVR) versus cardiac transplantation (CTx). We retrospectively analyzed hospital charges, length of stay (LOS), and survival for 69 SVR and 53 CTx patients at our institution between January 2002 and June 2005. We also compared New York Heart Association (NYHA) status and Kaplan-Meier survival of our SVR patients with CTx patients with ischemic cardiomyopathy from the International Society of Heart & Lung Transplantation (ISHLT) registry. Median total LOS (12 days vs. 17 days, P = .01) and median postoperative LOS (10 days vs. 15 days, P = .02) were shorter for SVR patients than our CTx patients. Median total hospital charges ($45,506 vs. $137,679, P < .0001) and median total drug charges ($2,625 vs. $15,930, P < .0001) were lower for SVR patients. Significant improvements in ejection fraction were seen after both SVR (27% vs. 37%; P < .0001) and CTx (14% vs. 62%, P < .0001). Furthermore, 91% (49/54) of surviving...Continue Reading

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Citations

Jun 16, 2015·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Minoru YoshidaTadashi Isomura
Feb 7, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sabrina P LawJoseph W Rossano
Apr 13, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·John Conte
Nov 15, 2012·Nature Reviews. Cardiology·Gerald BuckbergJohn Conte
Apr 21, 2018·Transplantation·Justin GodownDebra A Dodd
Sep 9, 2021·Journal of Cardiac Surgery·Ali Fatehi HassanabadImtiaz S Ali

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