Related Experiment Video
Updated: Feb 4, 2026

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
Published on: October 24, 2018
Extracorporeal Membrane Oxygenation Related Axillary Artery Cannulation and Aortic Hemodynamics: Insights From
Jan Coveliers1,2,3, Emanuele Gasparotti4, Emanuele Vignali4
1From the Cardio-Thoracic Surgery Department, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
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.
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