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Eur J Cardiothorac Surg 2004;25:261-266
© 2004 Elsevier Science NL

Clinical evaluation of a new fat removal filter during cardiac surgery

^a Department of Anesthesiology, University Hospital Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
^b Department of Cardiothoracic Surgery, University Hospital Groningen, Groningen, The Netherlands
^c Department of Medical Technology Assessment, University Hospital Groningen, Groningen, The Netherlands
^d Department of Biomedical Engineering, University Hospital Groningen, Groningen, The Netherlands

Received 19 February 2003; received in revised form 17 October 2003; accepted 10 November 2003.

^* Corresponding author. Tel.: +31-5036-13-637; fax: +31-5036-13-763
e-mail: a.j.de.vries{at}anest.azg.nl

Objective: Fat microemboli are generated during cardiac surgery that are associated with post-operative organ injury. Recently, a fat removal filter has been developed, based on a polyester leukocyte depletion filter. However, the efficacy of such a filter in a clinical setting is unknown. In this study we tested the efficacy of this filter. Methods: Coronary artery bypass patients were randomly divided into two groups. Group I: filtration of cardiotomy suction blood during cardiopulmonary bypass with a fat removal filter (n=14). Group II: control patients without filtration (n=14). Filter efficacy was evaluated in group I using biochemical assays and thin layer chromatography of blood samples taken simultaneously before and after the filter. In addition, clinical and biochemical markers for organ injury were determined in both groups. Results: The fat filter removed triglycerides (0.9±0.08 vs. 0.63±0.08 mmol l^-1, P=0.004, paired t-test), leukocytes (4.3±0.8x10⁹ vs. 2.3±0.6x10⁹ l^-1, P=0.03), and platelets (116±26x10⁹ vs. 75±21x10⁹ l^-1, P=0.003) from the blood samples taken before and after the filter. Chromatography showed a significant reduction in free fatty acids, phospholipids and triglycerides. Clinically, leukocyte counts were similar, but platelet counts were higher (181±14x10⁹ vs. 117±8.6x10⁹ l^-1 control, P<0.001) in group I on the first postoperative day. Conclusion: The fat filter removed 40% fat, leukocytes and platelets from cardiotomy suction blood during cardiac surgery. A larger scale study is necessary to determine clinical effects on organ damage.

Key Words: Fat • Filtration • Cardiac surgery

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