[HSF] Embol-X

[Jean BACHET]

Dear Ani,

another cause of stroke in our patients may be air embolism. Do you use  TOE
to check that any air  has been eliminated from te left cardiac cavities
before discontinuing suction?  Personally I am frightened by this
possibility of air embolism (I have seen a few devastating examples in my
carrer) and I de-air with two sucking lines, one in the left ventricle and
one in the ascending aorta, for at least 10 minutes after unclamping and a
few minutes after an almost normal systolic pressure ( 70-80 mmHg) has been
restored. When TOE is in place (which is not the case in all patients) I
wait until any kind of turbulence or bubble like image has disappeared. It
might be overcautious but I really consider air embolism as a surgical
mistake, which is not the case with atheromatous debris embolism which, in
many cases, cannot be foreseen and prevented. (Afterall the patients may be
responsible for something from time to time!)

Jean Bachet.

----- Original Message ----- 
From: "Ani Anyanwu" <anianyanwu at hotmail.com>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Thursday, March 01, 2007 3:38 AM
Subject: Re: [HSF] Embol-X


I would like to know list members experience in using the Embol-X
intra-aortic filter - indications and capture rate. I know some - notably
Hal - have said they use it on all valves - what prompted this?

I ask because in the last two weeks we have had two devastating strokes in
40 year olds undergoing degenerative mitral repair, having not had a single
stroke in almost 300 degenerative repairs in our institution the preceding 2
years and am wondering if one should consider using this device routinely.
At present we have used it only in cases with high embolic risk and even
then our yield has been low.

Thank you

Ani Anyanwu
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