A prospective clinical study of cerebral microemboli and neuropsychological outcome comparing vent-line and auto-venting arterial line filters: both filters are equally safe

Introduction: Microemboli are the main implicated cause of neuropsychological (NP) impairment after cardiac surgery. This prospective clinical trial compared the effect of an auto-venting arterial line filter on intraoperative cerebral microemboli and NP outcome compared to an arterial line filter w...

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Bibliographic Details
Published in:Perfusion 2006-03, Vol.21 (2), p.83-86
Main Authors: Whitaker, Donald C, Stygall, Jan, Hope-Wynne, Chris, Walesby, Robin K, Harrison, Michael JG, Newman, Stanton P
Format: Article
Language:English
Subjects:
Aged
Extracorporeal Circulation - adverse effects
Extracorporeal Circulation - instrumentation
Female
Filtration - instrumentation
Humans
Intracranial Embolism - diagnosis
Intracranial Embolism - diagnostic imaging
Intracranial Embolism - prevention & control
Male
Middle Aged
Middle Cerebral Artery - diagnostic imaging
Neuropsychological Tests
Prospective Studies
Treatment Outcome
Ultrasonography, Doppler, Transcranial - methods
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Summary:Introduction: Microemboli are the main implicated cause of neuropsychological (NP) impairment after cardiac surgery. This prospective clinical trial compared the effect of an auto-venting arterial line filter on intraoperative cerebral microemboli and NP outcome compared to an arterial line filter with a vent line, in patients undergoing elective coronary artery bypass graft (CABG) surgery. Methods: One hundred and ten patients received either an Avecor Affinity (n = 73) or Pall AV-6 (n = 37) control filter. Cerebral microemboli during cardiopulmonary bypass were recorded by transcranial Doppler monitoring of the right middle cerebral artery. Evidence of cerebral impairment was obtained by comparing patients’ performance in a NP test battery (nine tests) administered 6-8 weeks postoperatively with their pre-operative scores. Results: During cardiopulmonary bypass, the median number and range of microemboli were 67 (5-846) and 55 (2-773) for the Avecor and AV-6 groups, respectively (p = 0.47). There was no difference in NP outcome. Conclusion: There is no difference in the filtering ability of vent-line and auto-vent filters as assessed by cerebral microemboli. This, together with the similar NP outcome, suggests that both types of filter are equally safe for clinical use.
ISSN:0267-6591
1477-111X
DOI:10.1191/0267659106pf852oa