Myocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty

Objective: To compare the costs of coronary bypass surgery (CBS) and percutaneous transluminal coronary angioplasty (PTA) over a one-year follow up. Method: Eight-six patients were submitted to 87 CBS and 240 patients to 267 PTA, between October 2003 and April 2004. The mean age of the two groups was 62 years. The CBS group was submitted to a mean of 3.7 bypasses/patient, using 96.5% of arterial conduits. In the PTA group, a mean of 1.1 angioplasties / procedure were performed. Twenty-one (24.4%) patients had an angioplasty performed before the CBS. Each group was subdivided in, Subgroup A and B, in respect to the manner of payment. Results: The mean cost for CBS was R$ 7.759,78, per procedure; in the PTA group the cost/angioplasty was R$ 6.307.79. At the end of a year, the end values were R$ 7.875,73 for the CBS and R$ 8.234,96 for the PTA group. In Subgroup B the CBS patients had a mean hospital cost of R$ 11.061.63 and R$ 11.087.29 at the end of a year; in the PTA group hospital costs were R$ 11.110,83, and at the end of a year R$ 13.414,59. Conclusions: The author concludes that: 1) only 26.4% of the 326 patients were submitted to CBS; 2) PTA group presented 26.7% re-interventions and CBS group only 3.5%; 3) CBS costs were 17.4% lower than those of the PTA Group after one year, for subgroup B. Descriptors: Myocardial revascularization. Costs and cost analysis. Coronary artery bypass. Angioplasty, transluminal, percutaneous coronary. Revascularização do miocárdio: estudo comparativo do custo da cirurgia convencional e da angioplastia transluminal percutânea Myocardial revascularization: comparative cost study between conventional coronary bypass and percutaneous transluminal coronary angioplasty