Elsevier

JACC: Cardiovascular Interventions

Clinical Research

Structural

Transcatheter Versus Surgical Closure of Atrial Septal Defects in Children: A Value Comparing

Abstruse

Objectives

The purpose of this study was to make up one's mind whether a transcatheter process or surgical closure offers a better value proffer for atrial septal defect (ASD) closure.

Background

Secundum ASDs are mutual congenital center defects with both transcatheter and surgical treatment options. Although both options accept been shown to take excellent results in children, the relative value of the 2 procedures is unclear.

Methods

Using data from the Pediatric Hospital Information System for 2004 to 2012, we compared the value of transcatheter versus surgical ASD closure for children ages ane to 17 years, with value beingness defined as outcomes relative to costs. Full charges for process-related encounters were converted to costs using hospital-specific cost-to-accuse ratios, and all costs were adjusted for inflation to reflect 2012 dollars.

Results

In that location were 4,606 transcatheter procedures and 3,159 surgeries at 35 children's hospitals. Those undergoing transcatheter closure were more than likely to exist older (5.vi years vs. 4.five years, p < 0.0001). There was no mortality in either group. Children with a surgical procedure had a longer length of stay (4.0 days vs. 1.5 days, p < 0.0001), were more likely to accept an infection (odds ratio: 3.73, p < 0.0001) or procedural complexity (odds ratio: six.66, p < 0.0001). Costs for transcatheter procedure encounters were lower than costs for surgical encounters (mean of $19,128 vs. $25,359, p < 0.0001).

Conclusions

Both transcatheter and surgical ASD closure had splendid short-term outcomes, but transcatheter procedures had lower lengths of stay, rates of infection, and complications, resulting in lower overall costs. For children who are eligible, transcatheter ASD closure provides better short-term value than surgery.

Key Words

atrial septal defect

consequence

surgery

transcatheter

value

Abbreviations and Acronyms

PHIS

Pediatric Wellness Information System

Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.