{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:31:43Z","timestamp":1789723903913,"version":"4.0.1"},"reference-count":7,"publisher":"Texas Heart Institute Journal","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12]]},"abstract":"Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO's major limitations: in patients who have small-caliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft\u2014a well-described technique to avoid limb ischemia\u2014enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection.<\/jats:p>\n We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation.<\/jats:p>","DOI":"10.14503\/thij-14-4728","type":"journal-article","created":{"date-parts":[[2015,11,30]],"date-time":"2015-11-30T21:59:11Z","timestamp":1448920751000},"page":"537-539","source":"Crossref","is-referenced-by-count":16,"title":["Modified T-Graft for Extracorporeal Membrane Oxygenation in a Patient with Small-Caliber Femoral Arteries"],"prefix":"10.14503","volume":"42","author":[{"given":"Daniel","family":"Calderon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"El-Banayosy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Koerner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy B.","family":"Reed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5628","reference":[{"issue":"5","key":"i1526-6702-42-6-537-b1","series-title":"Ann Thorac Surg","first-page":"e111","article-title":"Side-arm grafts for femoral extracorporeal membrane oxygenation cannulation","volume":"94","year":"2012","unstructured":"Jackson\n KW, \n \n Timpa\n J, \n \n McIlwain\n RB, \n \n O'Meara\n C, \n \n Kirklin\n JK, \n \n Borasino\n S, \n \n Alten\n JA.\n \n \n Side-arm grafts for femoral extracorporeal membrane oxygenation cannulation. Ann Thorac Surg2012;94(5):e111\u20132."},{"issue":"2","key":"i1526-6702-42-6-537-b2","series-title":"Ann Thorac Surg","first-page":"626","article-title":"Vascular complications in patients undergoing femoral cannulation for extracorporeal membrane oxygenation support","volume":"92","year":"2011","unstructured":"Bisdas\n T, \n \n Beutel\n G, \n \n Warnecke\n G, \n \n Hoeper\n MM, \n \n Kuehn\n C, \n \n Haverich\n A, \n \n Teebken\n OE.\n \n \n Vascular complications in patients undergoing femoral cannulation for extracorporeal membrane oxygenation support. Ann Thorac Surg2011;92(2):626\u201331."},{"issue":"1","key":"i1526-6702-42-6-537-b3","series-title":"Ann Vasc Surg","first-page":"178","article-title":"Arterial complications in patients undergoing extracorporeal membrane oxygenation via femoral cannulation","volume":"28","year":"2014","unstructured":"Aziz\n F, \n \n Brehm\n CE, \n \n El-Banayosy\n A, \n \n Han\n DC, \n \n Atnip\n RG, \n \n Reed\n AB.\n \n \n Arterial complications in patients undergoing extracorporeal membrane oxygenation via femoral cannulation. Ann Vasc Surg2014;28(1):178\u201383."},{"issue":"3","key":"i1526-6702-42-6-537-b4","series-title":"Ann Thorac Surg","first-page":"892","article-title":"Late vascular complications after extracorporeal membrane oxygenation support","volume":"81","year":"2006","unstructured":"Zimpfer\n D, \n \n Heinisch\n B, \n \n Czerny\n M, \n \n Hoelzenbein\n T, \n \n Taghavi\n S, \n \n Wolner\n E, \n \n Grimm\n M.\n \n \n Late vascular complications after extracorporeal membrane oxygenation support. Ann Thorac Surg2006;81(3):892\u20135."},{"issue":"4","key":"i1526-6702-42-6-537-b5","series-title":"J Vasc Surg","first-page":"850","article-title":"Limb ischemia during femoral cannulation for cardiopulmonary support","volume":"52","year":"2010","unstructured":"Foley\n PJ, \n \n Morris\n RJ, \n \n Woo\n EY, \n \n Acker\n MA, \n \n Wang\n GJ, \n \n Fairman\n RM, \n \n Jackson\n BM.\n \n \n Limb ischemia during femoral cannulation for cardiopulmonary support. J Vasc Surg2010;52(4):850\u20133."},{"issue":"4","key":"i1526-6702-42-6-537-b6","series-title":"Tex Heart Inst J","first-page":"462","article-title":"TandemHeart insertion via a femoral arterial GORE-TEX graft conduit in a high-risk patient","volume":"35","year":"2008","unstructured":"Busch\n J, \n \n Torre-Amione\n G, \n \n Noon\n G, \n \n Loebe\n M.\n \n \n TandemHeart insertion via a femoral arterial GORE-TEX graft conduit in a high-risk patient. Tex Heart Inst J2008;35(4):462\u20135."},{"issue":"4","key":"i1526-6702-42-6-537-b7","series-title":"Ann Thorac Surg","first-page":"1335","article-title":"Arterial chimney graft cannulation for interventional lung assist","volume":"94","year":"2012","unstructured":"Burkle\n MA, \n \n Sodian\n R, \n \n Kaczmarek\n I, \n \n Weig\n T, \n \n Frey\n L, \n \n Irlbeck\n M, \n \n Dolch\n ME.\n \n \n Arterial chimney graft cannulation for interventional lung assist. Ann Thorac Surg2012;94(4):1335\u20137."}],"container-title":["Texas Heart Institute Journal"],"original-title":[],"link":[{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/42\/6\/article-p537.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/thij\/article-pdf\/42\/6\/537\/1970641\/thij-14-4728.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/42\/6\/article-p537.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/42\/6\/article-p537.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:30:58Z","timestamp":1730993458000},"score":1,"resource":{"primary":{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/42\/6\/article-p537.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":7,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.14503\/thij-14-4728","relation":{},"ISSN":["0730-2347","1526-6702"],"issn-type":[{"value":"0730-2347","type":"print"},{"value":"1526-6702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}