The Effect of Atrial Septal Defect in the Treatment of ARDS with Left Ventricular Dysfunction Simulating Severe COVID-19

Authors

  • Liwei Diao Shenzhen Hospital, University of Chinese Academy of Sciences, Guangdong, China
  • Yingjie Yang Third Hospital, Xinxiang Medical University, Henan, China
  • Baoquan Zhang Third Hospital, Xinxiang Medical University, Henan, China
  • Qizhong Shi Third Hospital, Xinxiang Medical University, Henan, China
  • Hongzhe Fan Third Hospital, Xinxiang Medical University, Henan, China
  • Jie Liu Third Hospital, Xinxiang Medical University, Henan, China
  • Yangyang Li Third Hospital, Xinxiang Medical University, Henan, China
  • Benqing Wu Shenzhen Hospital, University of Chinese Academy of Sciences, Guangdong, China
  • Yibin Wu Shenzhen Hospital, University of Chinese Academy of Sciences, Guangdong, China
  • Haiyi Qiu Shenzhen Hospital, University of Chinese Academy of Sciences, Guangdong, China
  • Wenbin Li Shenzhen Hospital, University of Chinese Academy of Sciences, Guangdong, China

DOI:

https://doi.org/10.1532/hsf.3077

Keywords:

COVID-19, Acute Respiratory Distress Syndrome, Left Ventricular Dysfunction, Atrial Septal Defect, Extracorporeal Membrane Oxygenation, Large Animal Experiments

Abstract

Objective: To explore the effect of atrial septal defect (ASD) and venoarterial extracorporeal membrane oxygenation (VA-ECMO) in the treatment of ARDS combined with left ventricular dysfunction (LVD) to find a new effective method for treating severe COVID-19 patients.

Materials and methods: Five large animal ARDS models of sheep were established by intravenous injection of
Lipopolysaccharide. ASD was made under general anesthesia and VA-ECMO was simulated by extracorporeal circulation machine. The oxygenation of peripheral blood, systemic circulation, and cardiac function were observed under conditions of closed and opened ASD, and the significance of ASD shunt in improving cardiopulmonary function was evaluated.

Results: With ASD closed, the atrial shunts disappeared, the peripheral artery pressure of oxygen(PaO2): 141.2±21.4mmHg, the oxygenation index (PaO2/FiO2): 353.0±53.5, the mean blood pressure (MAP): 49.3±13.5 mmHg, the heart was full; with ASD opened, the left-to-right shunt was observed, PaO2: 169.3±18.9mmHg, PaO2/FiO2: 423.3±47.3, MAP: 68.2±16.1 mmHg, the range of cardiac motion significantly increased, heart beat was powerful, and systemic circulation significantly improved. Statistical analysis showed that there were significant differences between opened and closed ASD (P < .01).

Conclusion: ASD plus VA-ECMO is an effective method for the treatment of ARDS combined with LVD, which is the main cause of death in severe COVID-19 patients. However, further clinical validation is needed.

References

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Published

2020-08-05

How to Cite

Diao, L., Yang, Y., Zhang, B., Shi, Q., Fan, H., Liu, J., Li, Y., Wu, B., Wu, Y., Qiu, H., & Li, W. (2020). The Effect of Atrial Septal Defect in the Treatment of ARDS with Left Ventricular Dysfunction Simulating Severe COVID-19. The Heart Surgery Forum, 23(5), E574-E578. https://doi.org/10.1532/hsf.3077

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