TY  - JOUR
A1  - Malinowski, Daniel
A1  - Fournier, Yvan
A1  - Horbach, Andreas
A1  - Frick, Michael
A1  - Magliani, Mirko
A1  - Kalverkamp, Sebastian
A1  - Hildinger, Martin
A1  - Spillner, Jan
A1  - Behbahani, Mehdi
A1  - Hima, Flutura
T1  - Computational fluid dynamics analysis of endoluminal aortic perfusion
JF  - Perfusion
N2  - Introduction: In peripheral percutaneous (VA) extracorporeal membrane oxygenation (ECMO) procedures the femoral arteries perfusion route has inherent disadvantages regarding poor upper body perfusion due to watershed. With the advent of new long flexible cannulas an advancement of the tip up to the ascending aorta has become feasible. To investigate the impact of such long endoluminal cannulas on upper body perfusion, a Computational Fluid Dynamics (CFD) study was performed considering different support levels and three cannula positions.

Methods: An idealized literature-based- and a real patient proximal aortic geometry including an endoluminal cannula were constructed. The blood flow was considered continuous. Oxygen saturation was set to 80% for the blood coming from the heart and to 100% for the blood leaving the cannula. 50% and 90% venoarterial support levels from the total blood flow rate of 6 l/min were investigated for three different positions of the cannula in the aortic arch. 

Results: For both geometries, the placement of the cannula in the ascending aorta led to a superior oxygenation of all aortic blood vessels except for the left coronary artery. Cannula placements at the aortic arch and descending aorta could support supra-aortic arteries, but not the coronary arteries. All positions were able to support all branches with saturated blood at 90% flow volume.

Conclusions: In accordance with clinical observations CFD analysis reveals, that retrograde advancement of a long endoluminal cannula can considerably improve the oxygenation of the upper body and lead to oxygen saturation distributions similar to those of a central cannulation.
KW  - computational fluid dynamics analysis
KW  - simulation
KW  - endoluminal
KW  - aortic perfusion
KW  - extracorporeal membrane oxygenation
Y1  - 2022
U6  - http://dx.doi.org/10.1177/02676591221099809
SN  - 1477-111X
VL  - 0
IS  - 0
SP  - 1
EP  - 8
PB  - Sage
CY  - London
ER  -