{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:52:30Z","timestamp":1777737150692,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Endoaortic balloon occlusion facilitates cardioplegic arrest during minimally invasive surgery (MIS). Studies have shown endoclamping to be as safe as traditional aortic clamping. We compared outcomes and hospital costs of endoclamping versus external aortic occlusion in a large administrative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      There were 52,882 adults undergoing eligible cardiac surgery (October 2015 to March 2020) identified in the Premier Healthcare Database. Endoclamp procedures (\n                      <jats:italic>n<\/jats:italic>\n                      = 419) were 1:3 propensity score matched to similar procedures using external aortic occlusion (\n                      <jats:italic>n<\/jats:italic>\n                      = 1,244). Generalized linear modeling measured differences in in-hospital complications (major adverse renal and cardiac events, including mortality, new-onset atrial fibrillation, acute kidney injury [AKI], myocardial infarction [MI], postcardiotomy syndrome, stroke\/transient ischemic attack [TIA], and aortic dissection) and length of stay (LOS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age was 63 years, and 53% were male (\n                      <jats:italic>n<\/jats:italic>\n                      = 882). The majority (93%,\n                      <jats:italic>n<\/jats:italic>\n                      = 1,543) were mitral valve procedures, and 17% of procedures (\n                      <jats:italic>n<\/jats:italic>\n                      = 285) were robot-assisted. Total hospitalization costs were not statistically significantly different between the 2 groups ($52,158 vs $49,839,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.06). The median LOS was significantly shorter in the endoclamp group (incident rate ratio = 0.87,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Mortality, atrial fibrillation, AKI, and stroke\/TIA were similar between the 2 groups. MI and postcardiotomy syndrome were lower in the endoclamp group (odds ratio [OR] = 0.14,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.006, and OR = 0.27,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.005). There were no aortic dissections in the endoclamp group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Aortic endoclamping in MIS was associated with similar costs, shorter LOS, no dissections, and comparably low mortality and stroke rates when compared with external clamping in this hospital billing dataset. These results demonstrate the clinical safety and efficacy of endoaortic balloon clamping in a real-world setting. Further studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845231185311","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T06:40:08Z","timestamp":1689576008000},"page":"338-345","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost and Clinical Outcomes Evaluation Between the Endoaortic Balloon and External Aortic Clamp in Cardiac Surgery"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1154-8018","authenticated-orcid":false,"given":"Husam H.","family":"Balkhy","sequence":"first","affiliation":[{"name":"University of Chicago Medicine, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene A.","family":"Grossi","sequence":"additional","affiliation":[{"name":"New York University Langone Health, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bob","family":"Kiaii","sequence":"additional","affiliation":[{"name":"University of California Davis Health, Sacramento, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7429-9365","authenticated-orcid":false,"given":"Shannon M.E.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences, Irvine, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Kitahara","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Sloane","family":"Guy","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifton","family":"Lewis","sequence":"additional","affiliation":[{"name":"University of Alabama School of Medicine, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.05.055"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0000000000000301"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.01.018"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.719687"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-20-3032"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv160"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.09.054"},{"key":"e_1_3_2_9_2","volume-title":"AATS 102nd Annual Meeting","author":"Balkhy H","unstructured":"Balkhy H, Grossi E, Murphy D, et al. Evaluation of endo-aortic balloon occlusion compared to external clamping in sternal-sparing mitral valve surgery: a STS database analysis. In: AATS 102nd Annual Meeting, Boston, MA, 14\u201317 May 2022, paper no. 48. Beverly, MA: The American Association for Thoracic Surgery."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2022.11.016."},{"key":"e_1_3_2_11_2","unstructured":"Premier Applied Sciences\u00ae Premier Inc. Premier Healthcare Database White Paper: data that informs and performs https:\/\/products.premierinc.com\/downloads\/PremierHealthcareDatabaseWhitepaper.pdf (2020 accessed 17 April 2023)."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2010.03332.x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0123"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.06.051"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.015"},{"key":"e_1_3_2_16_2","unstructured":"Liebold A Gorki H Albrecht G et al. Best myocardial protection technique in videoscopic mitral valve surgery\u2014endoaortic balloon occlusion or transthoracic clamping? 20ISMICS Annual Scientific Meeting https:\/\/meetings.ismics.org\/abstracts\/2020\/PC25.cgi (2020 accessed 17 April 2023)."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.08.072"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.11.041"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.21037\/jovs-2019-17"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0b013e318216be5c"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy489"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.21037\/jovs.2018.12.07"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivu394"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-020-01244-6"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845231185311","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845231185311","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845231185311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:18:49Z","timestamp":1777461529000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845231185311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1177\/15569845231185311"],"URL":"https:\/\/doi.org\/10.1177\/15569845231185311","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}