OBJECTIVES. Blockages in coronary arteries are treated with coronary artery bypass graft (CABG) surgery. For the surgery, clinicians remove or redirect blood vessels from other areas of the body and then reroute blood flow to the heart through those grafted blood vessels. However, these grafts have a high failure rate and patients often must undergo additional revascularization procedures. Venous External Support (VEST™) is an external stent for use in CABG surgery. The innovative aspects of VEST™ are that it is the only a vailable device which externally supports vein grafts. This aims to preserve graft patency, improve conduit haemodynamics and reduce lumen irregularities, wall tension and intimal hyperplasia, with the ultimate aim of reducing the progression of vein graft disease and therefore the need for reintervention. VEST™ is an adjunct to standard CABG surgery, during which vein graft support devices are not currently used.

METHODS. A cost-effectiveness analysis was conducted using a Markov model to assess the efficacy of the treatments compared (CABG adding VEST™ vs CABG not using vein graft support). Efficacy was defined as failure rate and additional revascularization procedures, the costs evaluated included VEST™ unit cost, CABG surgery, additional surgery. A probabilistic sensitivity analysis was developed to assess the robustness of the case base results.The costs are presented in USD. This study was conducted from the institutional perspective.

RESULTS. Adding VEST™ to CABG reduces failure and reintervention rates, VEST™ is an alternative less costly when compared to CABG not using vein graft support, $41,427.08 ($37,284.37-$$45,569.79) vs $62,239.58 ($56,015.62-$68,463.54), respectively. So VEST™ generates $20,812.50 ($18,731.25-$22,893.75) savings per patient. The cost-effectiveness base case analysis indicates that adding VEST™ to CABG surgery is a dominant alternative (for a cohort of 1,000 patients the potential savings are $20,812,500.00).

CONCLUSIONS. Adding VEST™ to CABG improves patients outcomes and generates important savings for the Mexican healthcare system.