Hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery: assessment using magnetic resonance imaging.
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.
Petzina
Rainer
R
Department of Medicine, Lund University Hospital, Lund, Sweden.
Ugander
Martin
M
Gustafsson
Lotta
L
Engblom
Henrik
H
Sjögren
Johan
J
Hetzer
Roland
R
Ingemansson
Richard
R
Arheden
Håkan
H
Malmsjö
Malin
M
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