The EmBlocker: efficiency of a new ultrasonic embolic protection device adjunctive to heart valve surgery.
OBJECTIVE
Perioperative cerebral microemboli in cardiac surgery are associated with postoperative neurologic complications. The EmBlocker (Neurosonix Ltd, Rehovot, Israel), a newly developed device should be positioned against the ascending aorta, and it produces an ultrasonic force expected to divert microemboli away from the cerebral vasculature and reduce cerebral emboli.


METHODS
Twenty-one consecutive patients, undergoing a valve procedure, were enrolled into this nonrandomized pilot study. The EmBlocker (Neurosonix Ltd) was positioned in 11 consecutive patients and activated for 1 minute (1.5 W/cm(2)) during seven selected aortic manipulations and for 10 minutes (0.5 W/cm(2)) intermittently after cross-clamp removal. Transcranial Doppler-based quantification of microembolic signals was performed in all patients.


RESULTS
The use of the EmBlocker showed a significant overall reduction of the cerebral microembolic signals of 53%.


CONCLUSIONS
The use of the EmBlocker during valve surgeries is associated with a reduction of perioperative cerebral microembolic signals. This new technology holds the potential to lower the risk of postoperative neurologic complications.
Sauren
Loes D
LD
Departments of Cardiothoracic Surgery and Clinical Neurophysiology, Academic Hospital Maastricht, Maastricht, the Netherlands. l.sauren@ctc.unimaas.nl
la Meir
Mark
M
Bolotin
Gil
G
van der Veen
Frederik H
FH
Heijmans
John H
JH
Mess
Werner H
WH
Maessen
Jos G
JG
D000368:Aged; D001011:Aorta; D001021:Aortic Valve / Q000601:surgery*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D010865:Pilot Projects; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014159:Transducers; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial