title: The "Central Sport Model": Extracorporeal Membrane Oxygenation Using the Innominate Artery for Smaller Patients as Bridge to Lung Transplantation.
abstract: Venoarterial extracorporeal membrane oxygenation (VA ECMO) may be used in patients with advanced cardiac or pulmonary failure. Arterial cannulation via the femoral arteries is suboptimal in many clinical scenarios because of associated complications and the potential for differential hypoxemia between the upper and lower body. To address these concerns, we typically use an upper body configuration (sport model) with right internal jugular and axillary or subclavian artery cannulation to allow a safe and durable means of providing VA ECMO support without differential hypoxemia. Unfortunately, this approach may not be feasible in smaller patients, whose vessels may preclude optimal use of the axillary or subclavian arteries and in those with systemic vasculopathy associated with connective tissue disorders. We describe a new approach for patients of small stature using the innominate artery through a mini-upper sternotomy in seven patients.
authors.affiliation: From the *Division of Cardiothoracic Surgery, Department of Surgery, †Division of Pediatric Cardiology, Department of Pediatrics, and ‡Division of Pulmonary, Allergy & Critical Care Medicine, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York.
authors.forename: Scott
authors.initials: S
authors.lastname: Chicotka
authors.forename: Erika B
authors.initials: EB
authors.lastname: Rosenzweig
authors.forename: Daniel
authors.initials: D
authors.lastname: Brodie
authors.forename: Matthew
authors.initials: M
authors.lastname: Bacchetta
mesh_terms: D000328:Adult; D016122:Brachiocephalic Trunk; D002404:Catheterization; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013348:Subclavian Artery