Cost Comparison of Endoscopic Vein Harvesting and Open Vein Harvesting in CABG

In a secondary analysis of the Randomized Endo-Vein Graft Prospective (REGROUP) trial, researchers compared health care resource costs and utilization between endoscopic vein harvesting (EVH) and open vein harvesting (OVH) during a coronary artery bypass grafting (CABG) surgery. According to lead author, Todd H. Wagner, and colleagues, “EVH was not associated with a reduction in costs for the index CABG procedure or follow-up care.”
The study, published in JAMA Network Open, included 1,150 participants scheduled for urgent or elective bypass surgery involving a vein graft. After randomization, 574 patients received OVH and 5576 received EVH. The primary measures of the analysis were discharge costs for the index procedure and follow-up costs.
Over a mean follow-up time of 33 months (standard deviation [SD] 19.9), the unadjusted mean costs for the CABG procedure were $76,607 (SD $43,883) for the EVH group, and $75,368 (SD $45,900) for the OVH group, which included facility, insurance, and physician-related costs.
Additionally, the researchers observed no significant differences in follow-up costs between the groups, though EVH was slightly higher with a mean cost increase of $302 (standard error $225) per patient per 90-day follow-up period. The findings were “highly robust to the statistical model,” the authors wrote.
Given the comparable health care resource costs and utilization between the two procedural techniques, the authors concluded that “the choice to provide EVH may be based on surgeon and patient preferences.”