Minimally invasive approach associated with lower resource utilization after aortic and mitral valve surgery

• Published in: JTCVS open 2023-09, Vol.15, p.72-80
• Main Authors: Yang, NaYoung K., Soliman, Fady K., Pepe, Russell J., Palte, Nadia K., Yoo, Jin, Nithikasem, Sorasicha, Laraia, Kayla N., Chakraborty, Abhishek, Chao, Joshua C., Sunagawa, Gengo, Takebe, Manabu, Lemaire, Anthony, Ikegami, Hirohisa, Russo, Mark J., Lee, Leonard Y.
• Format: Article
• Language: English
• Subjects: Adult: Aortic Valve; high-resource utilization; left heart valve surgery; minimally-invasive surgery
• ISSN: 2666-2736; 2666-2736
• DOI: 10.1016/j.xjon.2023.06.007

To investigate the effect of minimally invasive cardiac surgery (MICS) on resource utilization, cost, and postoperative outcomes in patients undergoing left-heart valve operations. Data were retrospectively reviewed for patients undergoing single-valve surgery (eg, aortic valve replacement, mitral valve replacement, or mitral valve repair) at a single center from 2018 to 2021, stratified by surgical approach: MICS vs full sternotomy (FS). Baseline characteristics and postoperative outcomes were compared. Primary outcome was high resource utilization, defined as direct procedure cost higher than the third quartile or either postoperative LOS ≥7 days or 30-day readmission. Secondary outcomes were direct cost, length of stay, 30-day readmission, in-hospital and 30-day mortality, and major morbidity. Multiple regression analysis was conducted, controlling for baseline characteristics, operative approach, valve operation, and lead surgeon to assess high resource utilization. MICS was correlated with a significantly lower rate of high resource utilization (MICS, 31.25% [n = 115] vs FS 61.29% [n = 76]; P