Particulate emboli capture by an intra-aortic filter device during aortic valve replacement

Objective: This study aims to analyze the embolic activity in patients with calcified aortic stenosis who underwent aortic valve replacement using intra-aortic filtration with an EMBOL-X(R) System device (Edwards Lifesciences; Inc., Mountain View, CA, USA). Methods: From January 2007 to July 2007, 13 consecutive patients with calcified aortic stenosis, who underwent isolated aortic valve replacement using intra-aortic filtration by an EMBOL-X(R) System for 5 minutes after aortic clamp release, were evaluated. Mean patient age was 63.7 years (range 34 to 79 years) and 61.5% were female. The mean bypass time was 60.2 +/- 7.5 minutes (range 45 to 72 minutes) and the mean cross-clamp time was 50 7.5 minutes (range 35 to 63 minutes). Following removal, each filter was fixed in formalin and analyzed macroscopically with the captured fragments being counted. Histological examinations of the captured material were performed. Results: There were no strokes or gross neurological events. There were no cases of postoperative renal failure. No deaths were reported during hospitalization. Particulate emboli were found in five (38.5%) of the filters. On histological analysis of the particulate emboli captured, two (40%) contained fibrin, two (40%) presented conjunctive tissue, one (20%) contained red blood cells and in one it was not possible to determine the nature of the particulates captured. Conclusion: The EMBOL-X(R) System device was effective in particulate emboli capture in aortic valve replacement surgery of patients with calcified aortic stenosis.