Related Experiment Video
Updated: Mar 30, 2026
Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Cost comparison of Transcatheter and Operative Pulmonary Valve Replacement (from the Pediatric Health Information
Michael L O'Byrne1, Matthew J Gillespie2, Russell T Shinohara2
1Division of Cardiology, Children's National Medical Center, Washington, D.C.; Department of Pediatrics, The George Washington School of Medicine, Washington, D.C..
Insights
The short-term costs for transcatheter pulmonary valve replacement (TC-PVR) and surgical pulmonary valve replacement (S-PVR) are comparable. This study found no significant difference in overall costs between the two pulmonary valve replacement methods.
Area of Science:
- Cardiovascular Surgery
- Medical Economics
- Health Services Research
Background:
- Pulmonary valve replacement (PVR) is a critical procedure for managing various heart conditions.
- Both transcatheter pulmonary valve replacement (TC-PVR) and surgical pulmonary valve replacement (S-PVR) offer excellent patient outcomes.
- Understanding the cost-effectiveness of these procedures is crucial for healthcare providers and patients.
Purpose of the Study:
- To compare the short-term costs of transcatheter pulmonary valve replacement (TC-PVR) and surgical pulmonary valve replacement (S-PVR).
- To analyze secondary outcomes including length of stay, readmission risk, and departmental charges associated with each PVR method.
Main Methods:
- Retrospective cohort study of pediatric and adult patients undergoing PVR (age ≥ 8 years) between 2011 and 2013.
- Data from 35 centers contributing to the Pediatric Health Information Systems database.
- Propensity score-adjusted multivariable analysis to control for confounding factors and compare costs.
Main Results:
- No significant difference in the observed or adjusted total costs between TC-PVR and S-PVR (2013 US $50,030 vs $51,297).
- TC-PVR was associated with a shorter length of stay but higher clinical and supply charges.
- S-PVR incurred greater laboratory, pharmacy, and other departmental charges.
- No significant difference in 7- or 30-day readmission risks for either procedure.
Conclusions:
- Short-term healthcare costs for TC-PVR and S-PVR are not significantly different after statistical adjustment.
- While specific cost components vary between TC-PVR and S-PVR, the overall financial impact is comparable in the short term.
- Further research may explore long-term cost-effectiveness and patient-reported outcomes for both PVR modalities.
Abstract:
Outcomes for transcatheter pulmonary valve replacement (TC-PVR) and operative pulmonary valve replacement (S-PVR) are excellent. Thus, their respective cost is a relevant clinical outcome. We performed a retrospective cohort study of children and adults who underwent PVR at age ≥ 8 years from January 1, 2011, to December 31, 2013, at 35 centers contributing data to the Pediatric Health Information Systems database to address this question. A propensity score-adjusted multivariable analysis was performed to adjust for known confounders. Secondary analyses of department-level charges, risk of re-admission, and associated costs were performed. A total of 2,108 PVR procedures were performed in 2,096 subjects (14% transcatheter and 86% operative). The observed cost of S-PVR and TC-PVR was not significantly different (2013US $50,030 vs 2013US $51,297; p = 0.85). In multivariate analysis, total costs of S-PVR and TC-PVR were not significantly different (p = 0.52). Length of stay was shorter after TC-PVR (p <0.0001). Clinical and supply charges were greater for TC-PVR (p <0.0001), whereas laboratory, pharmacy, and other charges (all p <0.0001) were greater for S-PVR. Risks of both 7- and 30-day readmission were not significantly different. In conclusion, short-term costs of TC-PVR and S-PVR are not significantly different after adjustment.
