{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:05:54Z","timestamp":1779451554196,"version":"3.53.1"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To evaluate the cost-utility of minimal invasive extracorporeal circulation (MiECC) versus conventional cardiopulmonary bypass (cCPB) in coronary artery bypass grafting (CABG) over a 7-years horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A cohort-based, deterministic cost-utility model was constructed from the Greek NHS perspective over a 7-year period. Clinical inputs were derived from a meta-analysis including 4849 patients. Direct medical costs for intensive care unit (ICU) and ward stay, blood transfusions, intra-aortic balloon pump (IABP) use, and perfusion circuits were applied to estimate the cost of care. Quality of life was quantified in terms of quality-adjusted life years (QALYs) by mapping SF-36 data to EQ-5D utilities. Deterministic sensitivity analyses were used to test key assumptions and a probabilistic sensitivity analysis assessed overall result robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MiECC was associated with improved clinical outcomes, including lower perioperative mortality and complication rates, shorter mechanical ventilation duration, and reduced lengths of ICU and ward stay. Over 7 years, patients operated on MiECC accrued 2.21 QALYs versus 2.18 QALYs for cCPB. MiECC dominated cCPB, yielding both cost savings (\u0394Cost = \u22121369\u20ac) and a QALY gain (\u0394QALY = +0.03). Sensitivity analysis confirmed the robustness of the default results under all tested scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In an era focused on value-based care, cardiac centers and healthcare authorities should consider the integration of MiECC as a standard perfusion strategy in coronary surgery, given the supportive evidence of improved morbidity and mortality outcomes without financial impact concerns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261454559","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:23:33Z","timestamp":1779200613000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimal invasive extracorporeal circulation represents a dominant technique in coronary artery bypass grafting; insights from a cost-utility economic analysis"],"prefix":"10.1177","author":[{"given":"Nikolaos","family":"Maniadakis","sequence":"first","affiliation":[{"name":"National School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5451-4651","authenticated-orcid":false,"given":"Polychronis","family":"Antonitsis","sequence":"additional","affiliation":[{"name":"Aristotle University of Thessaloniki School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalampos","family":"Mylonas","sequence":"additional","affiliation":[{"name":"National School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriakos","family":"Anastasiadis","sequence":"additional","affiliation":[{"name":"Aristotle University of Thessaloniki School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezae354"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591221119002"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaf112"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.08.006"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.4178\/epih\/e2015014"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.08.1465"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198529446.001.0001"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.12681\/healthresj.26097"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462306051233"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00352.x"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659120929180"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv380"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12813"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591211026514"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659117712404"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261454559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261454559","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261454559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:16:22Z","timestamp":1779448582000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261454559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":15,"alternative-id":["10.1177\/02676591261454559"],"URL":"https:\/\/doi.org\/10.1177\/02676591261454559","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"article-number":"02676591261454559"}}