ASAIO Journal最新文献_第3页

Preemptive Versus Reactive Use of a Right Ventricular Assist Device in HeartMate 3 Patients. 在HeartMate 3患者中先发制人与反应性使用右心室辅助装置的比较。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2025-11-14 DOI: 10.1097/MAT.0000000000002609

Alice V Vinogradsky, Krushang Patel, Morgan K Moroi, Paul Kurlansky, Yanling Zhao, Yuji Kaku, Melissa A Hynds, Gabriel Sayer, Nir Uriel, Melana Yuzefpolskaya, Lorenzo Braghieri, Paolo Colombo, Koji Takeda

{"title":"Preemptive Versus Reactive Use of a Right Ventricular Assist Device in HeartMate 3 Patients.","authors":"Alice V Vinogradsky, Krushang Patel, Morgan K Moroi, Paul Kurlansky, Yanling Zhao, Yuji Kaku, Melissa A Hynds, Gabriel Sayer, Nir Uriel, Melana Yuzefpolskaya, Lorenzo Braghieri, Paolo Colombo, Koji Takeda","doi":"10.1097/MAT.0000000000002609","DOIUrl":"10.1097/MAT.0000000000002609","url":null,"abstract":"Severe right ventricular failure (RVF) is a morbid complication of left ventricular assist device insertion. The optimal timing of right ventricular assist device (RVAD) support remains controversial. We sought to evaluate outcomes associated with preemptive versus delayed RVAD insertion at the time of HeartMate 3 (HM3) implantation. We retrospectively reviewed 293 patients who underwent HM3 implantation between November 2014 and December 2022. A preemptive RVAD strategy was applied to select patients. Outcomes were compared to patients who did not require an RVAD and who required an RVAD after HM3 insertion (reactive RVAD). Thirty-three patients (11.3%) underwent preemptive RVAD insertion, whereas 229 (78.2%) had no RVAD, and 31 (10.5%) had a reactive RVAD. Reasons for preemptive RVADs were cardiogenic shock (n = 22, 66.7%), severe biventricular failure (n = 7, 21.2%), or refractory ventricular tachycardia (n = 4, 12.1%). In-hospital mortality was highest in the reactive group (None: 2.2 versus Preemptive: 3.0 versus Reactive: 25.8%, p < 0.001). Kaplan-Meier analysis showed the lowest 3 year survival in the reactive group, whereas the preemptive and non-RVAD groups had comparable survival rates (83.5% vs . 85.5% vs . 46.6%, p < 0.001). In multivariable Cox analysis, reactive RVAD was an independent risk factor for mortality (hazard ratio [HR]: 2.7, p < 0.001). In our study, preemptive RVAD insertion was associated with improved outcomes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"805-811"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous Right Ventricular Support via ProtekDuo Pulmonary Artery Cannulation. ProtekDuo肺动脉插管经皮右心室支持。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2025-11-25 DOI: 10.1097/MAT.0000000000002611

Jamila Kremer, Ana Julia Holler, Bastian Schmack, Arjang Ruhparwar, Matthias Karck, Anna Lassia Meyer

{"title":"Percutaneous Right Ventricular Support via ProtekDuo Pulmonary Artery Cannulation.","authors":"Jamila Kremer, Ana Julia Holler, Bastian Schmack, Arjang Ruhparwar, Matthias Karck, Anna Lassia Meyer","doi":"10.1097/MAT.0000000000002611","DOIUrl":"10.1097/MAT.0000000000002611","url":null,"abstract":"ProtekDuo dual-lumen cannula implantation provides effective percutaneous right ventricular support in acute right heart failure. This retrospective study analyzed 60 patients who received ProtekDuo support for a mean of 14.9 ± 9.7 days. Hemodynamic improvements included reduced central venous pressure (17.8 ± 5.6-11.8 ± 5.0 mmHg, p < 0.001) and increased central venous oxygen saturation (60.6 ± 15.2-74.6% ± 7.8%, p < 0.001). End-organ function improved, with lower creatinine (2.9 ± 5.0-1.6 ± 0.8 mg/dl, p = 0.046) and lactate levels (26.0 ± 23.3-14.1 ± 10.4 mg/dl, p < 0.001). Bilirubin levels increased post-implantation (2.9 ± 3.2 to 5.7 ± 6.0 mg/dl, p < 0.001) but returned to baseline within 13.5 ± 19 days in weaned patients. Independent mortality risk factors were female sex (hazard ratio [HR] = 6.47, p < 0.001), older age (HR = 1.035, p = 0.036), and higher body mass index (BMI) (HR = 1.124, p = 0.003). These findings highlight the benefits of percutaneous ProtekDuo implantation in acute right heart failure, although patient selection remains critical. Further studies are needed to refine selection criteria and optimize outcomes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"819-825"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognosis of Immunocompromised Patients With Respiratory Failure Managed With Venovenous Extracorporeal Membrane Oxygenation. 静脉-静脉体外膜氧合治疗免疫功能低下呼吸衰竭患者的预后。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2025-12-05 DOI: 10.1097/MAT.0000000000002615

Natsumi T Hamahata, Jonathan D Paladino, Makoto Uchiyama, Yusuke Hirao, Shunsuke Kondo, Ryota Sato

{"title":"Prognosis of Immunocompromised Patients With Respiratory Failure Managed With Venovenous Extracorporeal Membrane Oxygenation.","authors":"Natsumi T Hamahata, Jonathan D Paladino, Makoto Uchiyama, Yusuke Hirao, Shunsuke Kondo, Ryota Sato","doi":"10.1097/MAT.0000000000002615","DOIUrl":"10.1097/MAT.0000000000002615","url":null,"abstract":"Despite the increasing number of critically ill immunocompromised patients in intensive care unit, the outcome of different types of immunocompromised patients with respiratory failure managed with venovenous extracorporeal membrane oxygenation (VV ECMO) remains unclear. What is the overall mortality of immunocompromised patients with respiratory failure managed on VV ECMO compared to immunocompetent patients? Are there differences between different types of immunocompromised states? This is a systematic review and meta-analysis using MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for studies of any design that reported outcomes of immunocompromised adult patients managed on VV ECMO for respiratory failure. A total of 13 studies were included. The pooled mortality among immunocompromised patients undergoing VV ECMO was 63% (95% confidence interval [CI]: 49-76%, I2 : 94.23%), which was significantly higher than immunocompetent patients (odds ratio [OR]: 2.57, 95% CI: 1.22-5.41, p = 0.03, I2 : 48.18%). Among immunocompromised subgroups, only patients with hematologic malignancy exhibited significantly higher mortality (OR: 5.78, 95% CI: 1.07-31.29, p = 0.05, I2 : 0.00%). Immunocompromised patients with acute respiratory failure treated with VV ECMO were associated with higher mortality compared to immunocompetent patients. Mortality varied by underlying cause of immunosuppression, emphasizing the need for careful, individualized patient selection.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e279-e286"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to Letter to the Editor: Directional Bias and the Obesity Paradox in Venovenous ECMO. 致编辑的回复：静脉-静脉ECMO中的定向偏差和肥胖悖论。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 DOI: 10.1097/MAT.0000000000002873

Juan J Morales Behaine, Patrick M Wieruszewski, Juan G Ripoll

引用次数: 0

Reliable Flow, Cost-Effective, Comfortable: Tunneled Veno-Pulmonary Artery Extracorporeal Membrane Oxygenation Cannulation Technique. 可靠的流量，成本效益，舒适：隧道式静脉-肺动脉体外膜氧合插管技术。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2026-06-05 DOI: 10.1097/MAT.0000000000002747

Mohammad J Malik, John C Gurley, Jin Woo Chung, Dhruv Kothari, Matthias Loebe, Jasdeep S Dhaliwal, Masashi Kawabori

{"title":"Reliable Flow, Cost-Effective, Comfortable: Tunneled Veno-Pulmonary Artery Extracorporeal Membrane Oxygenation Cannulation Technique.","authors":"Mohammad J Malik, John C Gurley, Jin Woo Chung, Dhruv Kothari, Matthias Loebe, Jasdeep S Dhaliwal, Masashi Kawabori","doi":"10.1097/MAT.0000000000002747","DOIUrl":"10.1097/MAT.0000000000002747","url":null,"abstract":"Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) has many limitations, including patient comfort and, oftentimes, mobility issues. Veno-pulmonary (VP) ECMO offers respiratory support without recirculation and right heart support. For longer mechanical circulatory support (MCS) and improved mobility, non-femoral cannulation is preferred. The current standard is a double-lumen single-cannula via the right internal jugular vein. This requires cannula fixation to the head with a headband, which limits head movement and is uncomfortable due to its size. Flow fluctuations can also occur with cannula position. To address the limitations of VV ECMO and dual-lumen single-cannula PV ECMO, we developed a VP ECMO tunneling technique similar to tunneled catheters, utilizing two separate cannulae. Ten patients underwent this procedure at our institution with zero complications, vascular injuries, or cannula kinks. Maximum flow reached 5.2 L/min. Patients maintained head mobility and upper extremity function comfortably over a month period. This technique improves patient comfort, ensures stable cannula position, maintains reliable flow, and is cost-effective.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e315-e317"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Meet the Authors. 见见作者。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2026-09-28 DOI: 10.1097/01.mat.0001278632.02353.c4

引用次数: 0

Noninvasive Outflow Graft Flow Waveform Assessment Using Echocardiography and the HeartMate 3 Snoopy: A Mock Loop Study. 使用超声心动图和HeartMate 3 Snoopy进行无创流出性移植物血流波形评估：模拟环路研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2025-12-22 DOI: 10.1097/MAT.0000000000002610

Ricardo C Deveza, Mina Saweris, Desiree Robson, Pankaj Jain, Sumita Barua, Christian Said, Theodore Abart, Gregor Widhalm, Kavitha Muthiah, Thomas Schlöglhofer, Christopher Hayward

{"title":"Noninvasive Outflow Graft Flow Waveform Assessment Using Echocardiography and the HeartMate 3 Snoopy: A Mock Loop Study.","authors":"Ricardo C Deveza, Mina Saweris, Desiree Robson, Pankaj Jain, Sumita Barua, Christian Said, Theodore Abart, Gregor Widhalm, Kavitha Muthiah, Thomas Schlöglhofer, Christopher Hayward","doi":"10.1097/MAT.0000000000002610","DOIUrl":"10.1097/MAT.0000000000002610","url":null,"abstract":"The instantaneous left ventricular assist device (LVAD) flow waveform of the HeartWare ventricular assist device (HVAD) device was previously used to assess hemodynamic parameters, which is not possible with the HeartMate 3 (HM3). The purpose of this study was to assess the ability of pulsed wave Doppler interrogation of the outflow graft (PWOG) and of a novel noninvasive pump data acquisition system (HM3 Snoopy) to obtain noninvasive flow waveforms (NIFW) and to determine whether these predict hemodynamic changes. The study was conducted using a fluid-filled, biventricular failure mock loop model with a flow probe (FP) placed around the distal outflow. Five different pump speeds, two distinct hematocrits, and preload and afterload changes were used to create 56 unique hemodynamic states. Noninvasive flow waveform parameters were assessed for correlation against FP-derived parameters. Subsequently, NIFW parameters were assessed for their predictive capabilities for preload and afterload changes. There was moderate correlation between NIFW and FP-derived systolic waveform parameters ( r range: 0.43-0.81), and strong correlation for diastolic parameters ( r range: 0.87-0.99). Flow waveform amplitude as obtained by echocardiography was the best preload predictor ( r2 = 0.67). A multiple linear regression model of NIFW parameters provided adequate prediction of afterload ( r2 = 0.85). HeartMate 3 Snoopy and PWOG are promising tools for generating flow waveform surrogates and detecting hemodynamic changes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"812-818"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trauma Extracorporeal Membrane Oxygenation in Argentina: Complications, Mortality, and Long-term Outcomes. 阿根廷创伤体外膜氧合：并发症、死亡率和长期结果。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2025-12-11 DOI: 10.1097/MAT.0000000000002614

Federico Carini, Débora Belén Ávila Poletti, Sofía Schverdfinger, Sonia Villarroel, Antonela Guadalupe Baialardo, Horacio Adriel Armandola, Santiago Gastón Bruno, Rafael Ávila, Aracelly Pérez, Renzo Núñez, Susana Bauque, Christian Casabella, Mariano Norese, Daniel Ivulich, Verónica Ester Monzón, Fernando Pálizas, Iván Alfredo Huespe, Néstor Carrizo

{"title":"Trauma Extracorporeal Membrane Oxygenation in Argentina: Complications, Mortality, and Long-term Outcomes.","authors":"Federico Carini, Débora Belén Ávila Poletti, Sofía Schverdfinger, Sonia Villarroel, Antonela Guadalupe Baialardo, Horacio Adriel Armandola, Santiago Gastón Bruno, Rafael Ávila, Aracelly Pérez, Renzo Núñez, Susana Bauque, Christian Casabella, Mariano Norese, Daniel Ivulich, Verónica Ester Monzón, Fernando Pálizas, Iván Alfredo Huespe, Néstor Carrizo","doi":"10.1097/MAT.0000000000002614","DOIUrl":"10.1097/MAT.0000000000002614","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) for trauma is underreported in Latin America. We conducted a cohort study in four centers from Argentina (2015-2024), including all adults with polytrauma (defined as Injury Severity Score [ISS] ≥ 16) who developed acute respiratory distress syndrome (ARDS) with refractory respiratory failure and received veno-venous ECMO. Extracorporeal membrane oxygenation-related complications, in-hospital mortality, and prognostic performance of established scores were assessed retrospectively; long-term health-related quality of life (QoL) was assessed prospectively. Thirty-one patients were analyzed. Bleeding occurred in 25.8% (major in 16.1%); oxygenator/circuit thrombosis in 22.6%. In-hospital mortality was 38.7% (95% confidence interval [CI]: 22-58). Discrimination was modest: area under the ROC curve (AUROC; 95% CI) of 0.62 (0.42-0.82) for ISS, 0.55 (0.33-0.76) for Acute Physiology and Chronic Health Evaluation II (APACHE II), and 0.53 (0.32-0.73) for respiratory ECMO survival prediction (RESP)-score. Among 19 survivors, 11 (57.9%) completed follow-up a median of 7 years after discharge; EuroQol 5-Dimension 3-Level (EQ-5D-3L) utility had a median of 0.743 (bootstrap 95% CI: 0.653-0.831), and Katz Index was 6, indicating preserved independence despite frequent pain/anxiety. Extracorporeal membrane oxygenation achieved 59% in-hospital survival with durable functional status, but the limited prognostic performance of established predictive models highlights the need for trauma-specific tools and structured rehabilitation and follow-up. Limitations include a small sample size and substantial loss of follow-up, restricting precision and generalizability.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e271-e278"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rehabilitation Course Through Compassionate Use of JenaValve Trilogy Heart Valve System in a Patient With Left Ventricular Assist Device: A Case Study. 通过富有同情心地使用JenaValve三部曲心脏瓣膜系统在左心室辅助装置患者中的康复过程：一个案例研究。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2026-02-10 DOI: 10.1097/MAT.0000000000002674

Kara Eid, Peyton Conti, Tim Robbins

{"title":"Rehabilitation Course Through Compassionate Use of JenaValve Trilogy Heart Valve System in a Patient With Left Ventricular Assist Device: A Case Study.","authors":"Kara Eid, Peyton Conti, Tim Robbins","doi":"10.1097/MAT.0000000000002674","DOIUrl":"10.1097/MAT.0000000000002674","url":null,"abstract":"Aortic insufficiency (AI) develops in approximately one-third of patients 3 years after continuous-flow left ventricular assist device (LVAD) implantation. Transcatheter aortic valve replacement (TAVR) has recently emerged as a potential option. However, the use of TAVR in patients with LVADs is limited. There are currently only two transcatheter valves, J-Valve and Trilogy Valve, available under expanded access for aortic regurgitation, particularly for patients with LVAD. This case describes a 47 year old male with destination HeartMate 3 LVAD complicated by methicillin-susceptible Staphylococcus aureus bacteremia and severe AI causing cardiogenic shock. Despite inotropic and pharmacologic support, his course was marked by profound deconditioning and fluctuating renal and hepatic function. After a multidisciplinary review, the patient underwent compassionate use of the Trilogy Valve. Post-procedure, he demonstrated marked functional recovery, improving from maximal assistance to independent ambulation, reaching 1,145 feet during 6 minute walk test, and achieving an Activity Measure Post-Acute Care Basic Mobility score of 24/24. The Trilogy Valve is currently under investigation in the ALIGN-AR studies, but has only been used in LVAD patients under compassionate use in the United States. Ongoing registry data (JENA-VAD) and future research are needed to validate procedural standardization, hemodynamic effects, and rehabilitation potential and outcomes in this high-risk population.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e325-e328"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Membrane Oxygenation Related Axillary Artery Cannulation and Aortic Hemodynamics: Insights From Computational Fluid Dynamics. 与腋动脉插管和主动脉血流动力学相关的体外膜氧合：来自计算流体动力学的见解。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-01 Epub Date: 2026-02-02 DOI: 10.1097/MAT.0000000000002617

Jan Coveliers, Emanuele Gasparotti, Emanuele Vignali, Paolo Meani, Marilena Mazzoli, Mariusz Kowalewski, Eliza Huizinga, Karthik Gutta, Giulia Piccirillo, Wouter Huberts, Hamed Moradi, Michele Di Mauro, Robert J Holtackers, Monique de Jong, Sandro Gelsomino, Domenico Paparella, Erik Körver, Arne Doddema, Michal Kawczinski, Sam Heuts, Elham Bidar, Dorela Haxhiademi, Simona Celi, Roberto Lorusso

{"title":"Extracorporeal Membrane Oxygenation Related Axillary Artery Cannulation and Aortic Hemodynamics: Insights From Computational Fluid Dynamics.","authors":"Jan Coveliers, Emanuele Gasparotti, Emanuele Vignali, Paolo Meani, Marilena Mazzoli, Mariusz Kowalewski, Eliza Huizinga, Karthik Gutta, Giulia Piccirillo, Wouter Huberts, Hamed Moradi, Michele Di Mauro, Robert J Holtackers, Monique de Jong, Sandro Gelsomino, Domenico Paparella, Erik Körver, Arne Doddema, Michal Kawczinski, Sam Heuts, Elham Bidar, Dorela Haxhiademi, Simona Celi, Roberto Lorusso","doi":"10.1097/MAT.0000000000002617","DOIUrl":"10.1097/MAT.0000000000002617","url":null,"abstract":"Axillary and subclavian artery cannulation for veno-arterial extracorporeal membrane oxygenation (V-A ECMO) offers clinical advantages but introduces complex flow dynamics within the aortic arch. This study employed patient-specific computational fluid dynamics (CFD) models derived from 10 computed tomography (CT)-based geometries to simulate ECMO flow via either the right axillary artery or left axillary artery access under varying levels of cardiac dysfunction. Three distinct flow behaviors were observed-descending-directed, arch-split, and retrograde aortic valve (AV)-directed patterns-depending on access site, support level, and aortic geometry. Right axillary artery access more frequently resulted in retrograde flow, particularly in type III arch configurations. In contrast, left axillary artery cannulation promoted antegrade or arch-split flow, independent of arch morphology. These findings suggest that left axillary artery access may provide more favorable antegrade flow hemodynamics in V-A ECMO, particularly when native cardiac output is impaired. Computational fluid dynamics modeling offers valuable insights to guide individualized cannulation strategies based on patient anatomy and cardiac function.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e287-e295"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0