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

Centre for Behavioural and Social Sciences in Medicine, University College London, London, UK

Jan Stygall

Centre for Behavioural and Social Sciences in Medicine, University College London, London, UK

Chris Hope-Wynne

The Middlesex Hospital, London, UK

Robin K Walesby

The Middlesex Hospital, London, UK

Michael JG Harrison

Reta Lila Weston Institute of Neurological Studies, London, UK

Stanton P Newman

Centre for Behavioural and Social Sciences in Medicine, University College London, London, UK, s.newman{at}ucl.ac.uk

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.

Perfusion, Vol. 21, No. 2, 83-86 (2006)
DOI: 10.1191/0267659106pf852oa


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