{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T08:49:20Z","timestamp":1766134160935,"version":"3.37.3"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Eng Tech"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Venoarterial extracorporeal membrane oxygenation (VA ECMO) is used in patients with refractory cardiac or cardio-pulmonary failure. Native ventricular output interacts with VA ECMO flow and may hinder sufficient oxygenation to the heart and the brain. Further on, VA ECMO leads to afterload increase requiring ventricular unloading. The aim of the study was to investigate aortic blood flow and oxygenation for various ECMO settings and cannula positions with a numerical model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Four different aortic cannula tip positions (ascending aorta, descending aorta, abdominal aorta, and iliac artery) were included in a model of a human aorta. Three degrees of cardiac dysfunction and VA ECMO support (50%, 75% and 90%) with a total blood flow of 6\u00a0l\/min were investigated. Additionally, the Impella CP device was implemented under 50% support condition. Blood oxygen saturation at the aortic branches and the pressure acting on the aortic valve were calculated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A more proximal tip orientation is necessary to increase oxygen supply to the supra-aortic and coronary arteries for 50% and 75% support. During the 90% support scenario, proper oxygenation can be achieved independently of tip position. The use of Impella reduces afterload by 8\u201317 mmHg and vessel oxygenation is similar to 50% VA ECMO support. Pressure load on the aortic valve increases with more proximal tip position and is decreased during Impella use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We present a simulation model for the investigation of hemodynamics and blood oxygenation with various mechanical circulatory support systems. Our results underline the intricate and patient-specific relationship between extracorporeal support, cannula tip orientation and oxygenation capacity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s13239-024-00739-w","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T20:24:09Z","timestamp":1719519849000},"page":"623-632","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Investigations of Differential Hypoxemia During Venoarterial Membrane Oxygenation with and Without Impella Support"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5582-6905","authenticated-orcid":false,"given":"Michael","family":"Neidlin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Amiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Hugenroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Steinseifer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"739_CR1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1177\/0267659119830513","volume":"34","author":"L Falk","year":"2019","unstructured":"Falk L, Sallisalmi M, Lindholm JA, Lindfors M, Frenckner B, Broom\u00e9 M, Broman LM. Differential hypoxemia during venoarterial extracorporeal membrane oxygenation. Perfusion. 2019;34:22\u20139. https:\/\/doi.org\/10.1177\/0267659119830513.","journal-title":"Perfusion"},{"key":"739_CR2","doi-asserted-by":"publisher","first-page":"S11-S18","DOI":"10.4103\/0971-9784.197791","volume":"20","author":"AL Jayaraman","year":"2017","unstructured":"Jayaraman AL, Cormican D, Shah P, Ramakrishna H. Cannulation strategies in adult veno-arterial and veno-venous extracorporeal membrane oxygenation: Techniques, limitations, and special considerations. Ann Card Anaesth. 2017;20:S11-S18. https:\/\/doi.org\/10.4103\/0971-9784.197791.","journal-title":"Ann Card Anaesth"},{"key":"739_CR3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s12471-018-1073-9","volume":"26","author":"CL Meuwese","year":"2018","unstructured":"Meuwese CL, Ramjankhan FZ, Braithwaite SA, Jonge N de, Jong M de, Buijsrogge MP, et al. Extracorporeal life support in cardiogenic shock: indications and management in current practice. Neth Heart J. 2018;26:58\u201366. https:\/\/doi.org\/10.1007\/s12471-018-1073-9.","journal-title":"Neth Heart J."},{"issue":"Suppl 2","key":"739_CR4","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1002\/ejhf.850","volume":"19","author":"P Meani","year":"2017","unstructured":"Meani P, Gelsomino S, Natour E, Johnson DM, La Rocca H-PB, Pappalardo F, et al. Modalities and Effects of Left Ventricle Unloading on Extracorporeal Life support: a Review of the Current Literature. Eur J Heart Fail. 2017;19 Suppl 2:84\u201391. https:\/\/doi.org\/10.1002\/ejhf.850.","journal-title":"Eur J Heart Fail"},{"key":"739_CR5","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1177\/0267659118794112","volume":"34","author":"DW Donker","year":"2019","unstructured":"Donker DW, Brodie D, Henriques JPS, Broom\u00e9 M. Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions. Perfusion. 2019;34:98\u2013105. https:\/\/doi.org\/10.1177\/0267659118794112.","journal-title":"Perfusion"},{"key":"739_CR6","doi-asserted-by":"publisher","first-page":"6993","DOI":"10.21037\/jtd.2018.11.103","volume":"10","author":"V Lo Coco","year":"2018","unstructured":"Lo Coco V, Lorusso R, Raffa GM, Malvindi PG, Pilato M, Martucci G, et al. Clinical complications during veno-arterial extracorporeal membrane oxigenation in post-cardiotomy and non post-cardiotomy shock: still the achille\u2019s heel. J Thorac Dis. 2018;10:6993\u20137004. https:\/\/doi.org\/10.21037\/jtd.2018.11.103.","journal-title":"J Thorac Dis"},{"key":"739_CR7","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1111\/aor.12700","volume":"41","author":"M Lindfors","year":"2017","unstructured":"Lindfors M, Frenckner B, Sartipy U, Bj\u00e4llmark A, Broom\u00e9 M. Venous Cannula Positioning in Arterial Deoxygenation During Veno-Arterial Extracorporeal Membrane Oxygenation-A Simulation Study and Case Report. Artif Organs. 2017;41:75\u201381. https:\/\/doi.org\/10.1111\/aor.12700.","journal-title":"Artif Organs"},{"key":"739_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/MAT.0000000000000755","volume":"65","author":"DW Donker","year":"2019","unstructured":"Donker DW, Brodie D, Henriques JPS, Broom\u00e9 M. Left Ventricular Unloading During Veno-Arterial ECMO: A Simulation Study. ASAIO J. 2019;65:11\u201320. https:\/\/doi.org\/10.1097\/MAT.0000000000000755.","journal-title":"ASAIO J"},{"key":"739_CR9","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1177\/03913988221115444","volume":"45","author":"M Jelenc","year":"2022","unstructured":"Jelenc M, Jelenc B, Novak R, Poglajen G. Left ventricular venting in veno-arterial extracorporeal membrane oxygenation: A computer simulation study. Int J Artif Organs. 2022;45:841\u20138. https:\/\/doi.org\/10.1177\/03913988221115444.","journal-title":"Int J Artif Organs"},{"key":"739_CR10","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1002\/ehf2.12751","volume":"7","author":"J Gehron","year":"2020","unstructured":"Gehron J, Schuster M, Rindler F, Bongert M, B\u00f6ning A, Krombach G, et al. Watershed phenomena during extracorporeal life support and their clinical impact: a systematic in vitro investigation. ESC Heart Fail. 2020;7:1850\u201361. https:\/\/doi.org\/10.1002\/ehf2.12751.","journal-title":"ESC Heart Fail"},{"key":"739_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-023-01413-z","author":"K Yambe","year":"2023","unstructured":"Yambe K, Ishii T, Yiu BYS, Yu ACH, Endo T, Saijo Y. Ultrasound vector flow imaging during veno-arterial extracorporeal membrane oxygenation in a thoracic aorta model. J Artif Organs 2023. https:\/\/doi.org\/10.1007\/s10047-023-01413-z.","journal-title":"J Artif Organs"},{"key":"739_CR12","doi-asserted-by":"publisher","first-page":"2281","DOI":"10.1007\/s10439-017-1875-8","volume":"45","author":"A Geier","year":"2017","unstructured":"Geier A, Kunert A, Albrecht G, Liebold A, Hoenicka M. Influence of Cannulation Site on Carotid Perfusion During Extracorporeal Membrane Oxygenation in a Compliant Human Aortic Model. Ann Biomed Eng. 2017;45:2281\u201397. https:\/\/doi.org\/10.1007\/s10439-017-1875-8.","journal-title":"Ann Biomed Eng"},{"key":"739_CR13","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1097\/MAT.0000000000001221","volume":"67","author":"FR Nezami","year":"2021","unstructured":"Nezami FR, Khodaee F, Edelman ER, Keller SP. A Computational Fluid Dynamics Study of the Extracorporeal Membrane Oxygenation-Failing Heart Circulation. ASAIO J. 2021;67:276\u201383. https:\/\/doi.org\/10.1097\/MAT.0000000000001221.","journal-title":"ASAIO J"},{"key":"739_CR14","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jbiomech.2018.07.037","volume":"79","author":"MC Stevens","year":"2018","unstructured":"Stevens MC, Callaghan FM, Forrest P, Bannon PG, Grieve SM. A computational framework for adjusting flow during peripheral extracorporeal membrane oxygenation to reduce differential hypoxia. J Biomech. 2018;79:39\u201344. https:\/\/doi.org\/10.1016\/j.jbiomech.2018.07.037.","journal-title":"J Biomech"},{"key":"739_CR15","doi-asserted-by":"publisher","first-page":"105041","DOI":"10.1016\/j.cmpb.2019.105041","volume":"182","author":"K Gu","year":"2019","unstructured":"Gu K, Guan Z, Lin X, Feng Y, Feng J, Yang Y, et al. Numerical analysis of aortic hemodynamics under the support of venoarterial extracorporeal membrane oxygenation and intra-aortic balloon pump. Comput Methods Programs Biomed. 2019;182:105041. https:\/\/doi.org\/10.1016\/j.cmpb.2019.105041.","journal-title":"Comput Methods Programs Biomed"},{"key":"739_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.medntd.2022.100183","author":"Y Xi","year":"2022","unstructured":"Xi Y, Li Y, Wang H, Sun A, Deng X, Chen Z, Fan Y. The impact of ECMO lower limb cannulation on the aortic flow features under differential blood perfusion conditions. Medicine in Novel Technology and Devices 2022. https:\/\/doi.org\/10.1016\/j.medntd.2022.100183.","journal-title":"Medicine in Novel Technology and Devices"},{"key":"739_CR17","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s12265-021-10143-7","volume":"15","author":"FR Nezami","year":"2022","unstructured":"Nezami FR, Ramezanpour M, Khodaee F, Goffer E, Edelman ER, Keller SP. Simulation of Fluid-Structure Interaction in Extracorporeal Membrane Oxygenation Circulatory Support Systems. J Cardiovasc Transl Res. 2022;15:249\u201357. https:\/\/doi.org\/10.1007\/s12265-021-10143-7.","journal-title":"J Cardiovasc Transl Res"},{"key":"739_CR18","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/s13246-022-01203-6","volume":"46","author":"A Wickramarachchi","year":"2023","unstructured":"Wickramarachchi A, Burrell AJC, Stephens AF, \u0160eman M, Vatani A, Khamooshi M, et al. The effect of arterial cannula tip position on differential hypoxemia during venoarterial extracorporeal membrane oxygenation. Phys Eng Sci Med. 2023;46:119\u201329. https:\/\/doi.org\/10.1007\/s13246-022-01203-6.","journal-title":"Phys Eng Sci Med"},{"key":"739_CR19","doi-asserted-by":"publisher","first-page":"409231","DOI":"10.1115\/1.4025983","volume":"7","author":"NM Wilson","year":"2013","unstructured":"Wilson NM, Ortiz AK, Johnson AB. The Vascular Model Repository: A Public Resource of Medical Imaging Data and Blood Flow Simulation Results. J Med Device. 2013;7:409231. https:\/\/doi.org\/10.1115\/1.4025983.","journal-title":"J Med Device"},{"key":"739_CR20","doi-asserted-by":"publisher","first-page":"70","DOI":"10.21037\/atm.2016.11.47","volume":"5","author":"E Pavlushkov","year":"2017","unstructured":"Pavlushkov E, Berman M, Valchanov K. Cannulation techniques for extracorporeal life support. Ann Transl Med. 2017;5:70. https:\/\/doi.org\/10.21037\/atm.2016.11.47.","journal-title":"Ann Transl Med"},{"key":"739_CR21","doi-asserted-by":"publisher","first-page":"2718","DOI":"10.1016\/j.jbiomech.2016.06.003","volume":"49","author":"M Neidlin","year":"2016","unstructured":"Neidlin M, Corsini C, Sonntag SJ, Schulte-Eistrup S, Schmitz-Rode T, Steinseifer U, et al. Hemodynamic analysis of outflow grafting positions of a ventricular assist device using closed-loop multiscale CFD simulations: Preliminary results. J Biomech. 2016;49:2718\u201325. https:\/\/doi.org\/10.1016\/j.jbiomech.2016.06.003.","journal-title":"J Biomech"},{"key":"739_CR22","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.memsci.2006.11.041","volume":"288","author":"J Zhang","year":"2007","unstructured":"Zhang J, Nolan TDC, Zhang T, Griffith BP, Wu ZJ. Characterization of membrane blood oxygenation devices using computational fluid dynamics. Journal of Membrane Science. 2007;288:268\u201379. https:\/\/doi.org\/10.1016\/j.memsci.2006.11.041.","journal-title":"Journal of Membrane Science"},{"key":"739_CR23","doi-asserted-by":"publisher","first-page":"A27-A34","DOI":"10.1093\/eurheartj\/suab006","volume":"23","author":"J Belohlavek","year":"2021","unstructured":"Belohlavek J, Hunziker P, Donker DW. Left ventricular unloading and the role of ECpella. Eur Heart J Suppl. 2021;23:A27-A34. https:\/\/doi.org\/10.1093\/eurheartj\/suab006.","journal-title":"Eur Heart J Suppl"},{"key":"739_CR24","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1111\/aor.13141","volume":"42","author":"S Wang","year":"2018","unstructured":"Wang S, Patel S, Izer JM, Clark JB, Kunselman AR, Wilson RP, \u00dcndar A. Impact of Different Perfusion Modalities on Coronary and Carotid Blood Flow Velocities in an Adult ECLS Swine Model. Artif Organs. 2018;42:918\u201321. https:\/\/doi.org\/10.1111\/aor.13141.","journal-title":"Artif Organs"},{"key":"739_CR25","doi-asserted-by":"publisher","first-page":"191752","DOI":"10.1098\/rsos.191752","volume":"7","author":"R Pons","year":"2020","unstructured":"Pons R, Guala A, Rodr\u00edguez-Palomares JF, Cajas JC, Dux-Santoy L, Teixid\u00f3-Tura G, et al. Fluid-structure interaction simulations outperform computational fluid dynamics in the description of thoracic aorta haemodynamics and in the differentiation of progressive dilation in Marfan syndrome patients. R Soc Open Sci. 2020;7:191752. https:\/\/doi.org\/10.1098\/rsos.191752.","journal-title":"R Soc Open Sci"},{"key":"739_CR26","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.medengphy.2016.01.003","volume":"38","author":"M Neidlin","year":"2016","unstructured":"Neidlin M, Sonntag SJ, Schmitz-Rode T, Steinseifer U, Kaufmann TAS. Investigation of hemodynamics during cardiopulmonary bypass: A multiscale multiphysics fluid-structure-interaction study. Med Eng Phys. 2016;38:380\u201390. https:\/\/doi.org\/10.1016\/j.medengphy.2016.01.003.","journal-title":"Med Eng Phys."},{"key":"739_CR27","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s13054-020-02849-y","volume":"24","author":"N Buchtele","year":"2020","unstructured":"Buchtele N, Staudinger T, Schwameis M, Sch\u00f6rgenhofer C, Herkner H, Hermann A. Feasibility and safety of watershed detection by contrast-enhanced ultrasound in patients receiving peripheral venoarterial extracorporeal membrane oxygenation: a prospective observational study. Crit Care. 2020;24:126. https:\/\/doi.org\/10.1186\/s13054-020-02849-y.","journal-title":"Crit Care"}],"container-title":["Cardiovascular Engineering and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13239-024-00739-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13239-024-00739-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13239-024-00739-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T16:12:11Z","timestamp":1732205531000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13239-024-00739-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["739"],"URL":"https:\/\/doi.org\/10.1007\/s13239-024-00739-w","relation":{},"ISSN":["1869-408X","1869-4098"],"issn-type":[{"type":"print","value":"1869-408X"},{"type":"electronic","value":"1869-4098"}],"subject":[],"published":{"date-parts":[[2024,6,27]]},"assertion":[{"value":"22 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}