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ABSTRACT 53
INTRAAORTIC FILTRATION: ZURICH EXPERIENCE
Natalie Drabe, M.D.; Gregor Zund, M.D.;Mario Lachat, M.D.;
Martin Kunz, M.D.;Marko Turina, M.D.University Hospital, Zurich,
Switzerland
Patients enrolled in the International Council of Emboli Management
(ICEM) multicenter prospective consecutive enrollment registry
of intraaortic filtration (741 total patients October 2000 (Zurich
= 50)) had multiple risk factors for neurologic events and higher
risk profiles than those reported by Roach and colleagues, which
showed an incidence of 3.1% type I neurologic outcomes and 3.0%
type II outcomes following cardiac surgery. Roach found the presence
of proximal aortic disease was the most significant risk factor.
|
Risk Factor
|
Roach |
ICEM |
Zurich |
|
Age >= 70 yr
|
31.9%
|
51.5% 344/668
|
30% 12/40
|
|
Proximal AO atherosclerosis
|
12.4%
|
39.3% 237/603
|
72.5% 29/40
|
|
History of neurologic disease
|
8.3%
|
11.5% 75/650
|
10% 4/40
|
|
Hypertension
|
57.2%
|
64.2% 421/656
|
65.0% 26/40
|
|
Diabetes
|
25.1%
|
18.7% 121/648
|
10% 4/40
|
Roachs study was limited to CABG patients; the ICEM group includes
all aortic cross-clamp procedures. Total incidence of type I events
in the ICEM group was 1.4%, less than the 3.1% reported in the
Roach study. Consistent with the high-risk profile of the total
registry population, there were 24 deaths (3.8%).
Early Zurich experience is consistent with that of the total
ICEM registry. Although ICEM patients presented with a high incidence
of risk factors, fewer adverse neurologic events were experienced.
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