Trial Lecture - time and place
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Adjudication committee
- First opponent: Professor Vibeke Elisabeth Hjortdal, Department of Clinical Medicine - Department of Thoracic and Cardiovascular Surgery T, Aarhus University, Denmark
- Second opponent: Professor Tone Merete Norekvål, Department of Clinical Science, University of Bergen
- Third member of the adjudication committee: Professor Drude Merete Fugelseth, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor II Knut Kvernebo, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
Principal Supervisor
Professor II, Erik Fosse, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
Summary
Surgery for congenital heart disease in childhood, often impair the function of the pulmonary valve, and may lead to repeated valve repairing procedures later in life. Until recently, surgery has been the only effective intervention option. During the last decade, percutaneous pulmonary valve implantation has become a nonsurgical treatment option. In Norway, the first patients were treated with this technique at Oslo University Hospital in 2007. The early experience worldwide indicated good short time results and reduced the numbers of open heart surgeries the patients had to undergo during a lifetime.
In our thesis we applied a combination of qualitative and quantitative research methods to shed light on differences in outcomes between percutaneous technique and the conventional surgical treatment. The aims of the thesis were: 1) How did patients and the patients’ next of kin experience the percutaneous pulmonary valve implantation method? 2) Were there differences in hospital costs between percutaneous pulmonary valve implantation and open-heart surgery? 3) Were there differences between the two methods in terms of psychosocial and clinical outcomes?
We found a considerable benefit in patient experiences and psychosocial function after percutaneous treatment. One may argue that patient-reported outcomes are the only real value measures for patients living with chronic disease. Studying the hemodynamic results, we found that the new treatment is in line with traditional surgery, but with fewer complications. When comparing the total in-hospital costs, we found the price of the interventional valve itself to represent a more important cost than even the long intensive care unit stay in the surgical group. With only a slight reduction in device cost, the new treatment will become cost effective for society.
Based on our findings, we assume that this mini-invasive method may have a positive impact on the patients’ well-being throughout the life cycle.
Additional information
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