title: Hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery: assessment using magnetic resonance imaging.
abstract: OBJECTIVE
  The hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery are debated. The aim of the present study was to quantify cardiac output and left ventricular chamber volumes after vacuum-assisted closure using magnetic resonance imaging, which is known to be the most accurate method for quantifying these measures.
  
  
  METHODS
  Six pigs had median sternotomy followed by vacuum-assisted closure treatment in the presence and absence of a paraffin gauze interface dressing. Cardiac output and stroke volume were examined using magnetic resonance imaging flow quantification (breath-hold and real-time). Chamber volumes were assessed using cine magnetic resonance imaging.
  
  
  RESULTS
  Cardiac output and stroke volume decreased immediately after application of negative pressures of 75, 125, and 175 mm Hg (13% +/- 1% decrease in cardiac output). Interposition of 4 layers of paraffin gauze dressing over the heart during vacuum-assisted closure therapy resulted in a smaller decrease in cardiac output (8% +/- 1%).
  
  
  CONCLUSIONS
  Vacuum-assisted closure therapy results in an immediate decrease in cardiac output, although to a lesser extent than shown previously. Covering the heart with a wound interface dressing lessens the hemodynamic effects of vacuum-assisted closure.
authors.affiliation: Department of Medicine, Lund University Hospital, Lund, Sweden.
authors.forename: Rainer
authors.initials: R
authors.lastname: Petzina
authors.forename: Martin
authors.initials: M
authors.lastname: Ugander
authors.forename: Lotta
authors.initials: L
authors.lastname: Gustafsson
authors.forename: Henrik
authors.initials: H
authors.lastname: Engblom
authors.forename: Johan
authors.initials: J
authors.lastname: Sjögren
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Richard
authors.initials: R
authors.lastname: Ingemansson
authors.forename: Håkan
authors.initials: H
authors.lastname: Arheden
authors.forename: Malin
authors.initials: M
authors.lastname: Malmsjö
mesh_terms: D000818:Animals; D001458:Bandages; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002320:Cardiovascular Physiological Phenomena; D006339:Heart Rate; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D013249:Sternum / Q000601:surgery*; D013318:Stroke Volume; D034421:Sus scrofa; D014618:Vacuum; D017725:Ventricular Pressure