[HSF] Embol-X

[Ajit Damle]

Tim,

 

I appreciate your sober and helpful response to Ani's query. My experience
is similar to yours.

 

I have used Embol-x in over a hundred patients and now have given up
primarily because of cost. Also, many times there is a small annoying leak
around the aortic purse string that I do not get with my usual aortic
cannula (I do not use a cardiotomy suction in the pericardium).

 

Ajit Damle

 

Ani,

 

I wonder if this Forum is the right place to expect a scientific answer. I
certainly do not mean to diminish the great advice we get from the many
experienced, skillful master surgeons on individual cases and " How I Do It"
stuff.  Still...........

 

 

Ajit Damle 

 

 

 

 

Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Timothy Sloan
Sent: Thursday, March 01, 2007 7:32 AM
To: OpenHeart-L at lists.hsforum.com
Subject: [HSF] Embol-X

 

Members:

 

One of our group has had experience with Embol-X catheters.  We have placed 

over 200 in the past several years that they have been out.  I was initially


asked to review the literature and the FDA information at the hospital.  Our


stroke rate for valves was approximately 1-2% pre Embol-X.  We routinely use


CO2 for all left sided surgery.  The cost was very high - $ 350  vs $9  for 

the standard arterial cannula.

 

However we felt the cost is nothing in comparison to someone waking up with 

a bad infarct.  The literature that was generated by the company to the FDA 

DID NOT SHOW statistically decreased CVA's, however it did show decreased 

acute renal insufficiency.  Our findings mimicked this.  We had no obvious 

stroke in our patients, however we did not perform all those elegant 

neurologic tests pre op and post op.

 

We also didn't have any of the complications associated with the Embol-X - 

aortic dissections etc..

 

The literature and the company always took pictures of the net to convince 

us that there was significant particulate matter.  The magnification in the 

photographs was much greater than our loops.

 

I guess that the bottom line is that this catheter cost $ 70,000  vs  $1800 

over three years and we didn't have a stroke.  Did we "prevent" a stroke - I


doubt that statistical significance was obtained.

 

We now use the Embol-X very selectively and I believe that within the next 

year it will be off our shelves.  We continue to irrigate profusely with 

cold saline after debridement and we use 5 liters of CO2 from opening the 

left side to final closure.

 

Hope this helps.

 

Tim Sloan

 

 

----- Original Message ----- 

From: "Jean BACHET" <jean.bachet at imm.fr>

To: <OpenHeart-L at lists.hsforum.com>

Sent: Thursday, March 01, 2007 4:36 AM

Subject: Re: [HSF] Embol-X

 

 

>

> ----- 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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