Myocardial Topical Negative Pressure

University dissertation from Department of Cardiothoracic Surgery, Clinical Sciences, Lund University

Abstract: The aim of this research was to find out if it is possible to increase myocardial microvasular blood flow by applying a topical negative pressure source directly onto the myocardium. Topical negative pressure is a relatively new wound healing technique. When used in wound therapy, topical negative pressure has been shown to increase microvascular blood flow, to stimulate granulation tissue formation, and to stimulate angiogenesis in the underlying tissue, mainly subcutaneous tissue and skeletal muscle. It was concluded that topical negative pressure of -50 mmHg applied over the LAD region induced a significant increase not only in local microvascular blood flow but also in total coronary blood flow in normal and ischemic myocardium. A significant correlation was found between coronary blood flow changes during TNP and laser Doppler signal. It was also concluded that of pressures between -50 mmHg to -150 mmHg, a TNP of -50 mmHg seems to be the most effective negative pressure, and that no zone of hypoperfusion was observed in the epicardium. And finally it was concluded that there where no significant difference between microvascular blood flow during 20 minutes of continuous and intermittent TNP at -50 mmHg. In conclusion, myocardial applied topical negative pressure may in the future, constitute an alternative therapeutic intervention to stimulate blood flow in the failing myocardium in patients with ischemic heart disease.