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Innovation In Anticalcification Technology In Heart Valves Leads To Lower Hospital Stay In Adults Undergoing Aortic Valve Replacement
Bart Meuris1, Mohammad Torky2, Tom Langenaeken1, Marie Lamberigts1, Peter Verbrugghe1.
1Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium, 2Tanta University, Tanta, Egypt.

OBJECTIVE: Adults below 65y old who require aortic valve replacement can choose between mechanical valve(MV), necessitating lifelong anticoagulation, or tissue valve without anticoagulation but carrying the risk of calcific tissue degeneration. The Inspiris-Resilia(I-R) heart valve combines an anticalcification technology, with a new stent frame, facilitating potential secondary intervention later. We investigated the effect of valve choice on hospital costs.
METHODS:
We analyzed all patients (n=398), between 40-65y of age, receiving an aortic valve (+/- combined procedures) during the last 6 years. Patients were divided into 3 cohorts; being MV (n=90), I-R valves (n=75) and other tissue valves (n=233). We compared length of intensive care unit stay (ICU) as well as total hospital stay. We assigned a fixed cost per hour ICU stay and per hospital day. Data are presented as means [with 95% confidence limits]. Statistics involved standard t-tests
RESULTS:
When comparing MV to I-R, both ICU stay (48h[33-64] versus 18h[9-21], p=0.001) and total hospital stay (10.3d[8.7-11.9] versus 6.6d[5.9-7.3], p<0.001) were significantly longer in patients with MV, despite a significantly younger age in the MV group (53y vs 58y, p<0.001). The shorter hospital stay remained valid both in single aortic valve procedures (6.7d vs 8.8d, p=0.08), as in combined procedures (6.5d vs 11.4d, p<0.001). These differences lead to a cost reduction of 1,980 in ICU stay and 2,824 in further hospital stay. Compared to other tissue valves, I-R also revealed a significantly shorter hospital stay (6.6d versus 12.8d, p=0.02), but these patients groups differ in overall co-morbidity profile.
CONCLUSIONS:
In the choice between mechanical valves and Inspiris-Resilia, choosing an innovative tissue valve reduces length of ICU stay, total hospital stay and therefore overall cost of hospitalization, most likely due to the absence of the start of anticoagulation therapy. Compared to other tissue valves, Inspiris-Resilia also showed decreased length of stay.


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