title: Variability in End-Organ Perfusion with Femoral-Femoral Venoarterial Extracorporeal Membrane Oxygenation: Aortographic Evidence.
abstract: In femoral-femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO), the outflow of oxygenated blood from the circuit enters the aorta in retrograde fashion. As a result, variability in end-organ oxygenation (e.g., cerebral vs. splanchnic) may arise-particularly, when the heart is unable to contribute forward flow. We present the case of a 74-year-old man supported by femoral-femoral VA-ECMO in whom aortography was used to visualize the retrograde distribution of arterial ECMO flow that can produce such differences in end-organ perfusion. We do this by describing a series of still images captured during the aortography; we then discuss the importance of monitoring end-organ oxygenation in this setting and outline several interventions that can ameliorate this flow phenomenon.
authors.forename: Andreas R
authors.initials: AR
authors.lastname: de Biasi
authors.forename: William J
authors.initials: WJ
authors.lastname: DeBois
authors.forename: Luke
authors.initials: L
authors.lastname: Kim
authors.forename: Arash
authors.initials: A
authors.lastname: Salemi
mesh_terms: D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001027:Aortography / Q000379:methods*; D001783:Blood Flow Velocity; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016896:Treatment Outcome