The use of RemoweLL oxygenator-integrated device in the prevention of the complications related to aortic valve surgery in the elderly patient: Preliminary results.
Background The effects of fat microembolization due to cardiopulmonary bypass are well known in cardiac surgery. Our aim is to evaluate the use of the RemoweLL device (Eurosets, Medolla, Italy) during elective aortic valve replacement in elderly patients (>70 years old) to rate its biochemical and clinical effects. The RemoweLL device is an oxygenator-integrated reservoir which combines two strategies for fat emboli and leucocytes removal: filtration and supernatant elimination. Methods Forty-four elderly patients were enrolled and assigned randomly to a Group A (standard device) and a Group B (RemoweLL). Biochemical effects were evaluated by blood samples, which were tested for white blood cells, neutrophils, protein SP-100 and interleukin 6 besides standard lab tests. Our clinical endpoints were any type of neurological, cardiac, respiratory, gastrointestinal or renal complications, and length of stay in the intensive care unit. Statistical analysis was carried out with chi square test for non-parametric data; t test and analysis of variance for repeated measures were used for parametric data. Results Group B showed lower levels of white blood cells, neutrophils, interleukin 6 and protein SP-100 immediately and 24 hours after the operation. Group B also showed a lower amount of neurocognitive type II dysfunction even if the length of stay in the ICU did not change. Conclusions The RemoweLL system is safe and effective in reducing inflammatory response to cardiopulmonary bypass and it could be a useful tool in minimizing negative effects of cardiopulmonary bypass; however, it does not seem to have any effect on elderly patients' hospital stay.
['Molardi|Alberto|A|', 'Di Chicco|Maria V|MV|', 'Carino|Davide|D|', 'Goldoni|Matteo|M|', 'Ricci|Matteo|M|', 'Borrello|Bruno|B|', 'Gripshi|Florida|F|', 'Gherli|Tiziano|T|', 'Nicolini|Francesco|F|']
D000368:Aged D001021:Aortic Valve D016207:Cytokines D017558:Elective Surgical Procedures D004867:Equipment Design D005260:Female D005500:Follow-Up Studies D006349:Heart Valve Diseases D019918:Heart Valve Prosthesis Implantation D006801:Humans D007958:Leukocyte Count D047589:Leukocyte Reduction Procedures D008297:Male D010106:Oxygenators D011183:Postoperative Complications D011446:Prospective Studies D012307:Risk Factors D016896:Treatment Outcome
aortic valve replacement CPB Leucocyte filtration fat removal prevention of neurological complications after valve surgery