ArticleComputers in biology and medicine2022
Effect of anatomical variation on extracorporeal membrane oxygenation circulatory support: A computational study.
Article in Computers in biology and medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Integrating bibliometric analysis and external validation of the SAVE score in VA-ECMO for refractory cardiogenic shock: insights from global trends and the MIMIC-IV database.Journal of thoracic disease · 2026Article
- Identification of pulmonary hypertension with pulmonary vascular surface volume ratio by non-contrast CT.BMC cardiovascular disorders · 2026Article
- Impact of aortic morphology on VA-ECMO performance: a combined statistical shape modeling and CFD approach.Frontiers in bioengineering and biotechnology · 2025Article
- Effect of upper body venoarterial ECMO on systemic hemodynamics and oxygenation: A computational study.Computers in biology and medicine · 2024Article
- A numerical study of the hemodynamic behavior and gas transport in cardiovascular systems with severe cardiac or cardiopulmonary failure supported by venoarterial extracorporeal membrane oxygenation.Frontiers in bioengineering and biotechnology · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundExtracorporeal membrane oxygenation (ECMO) via femoral cannulation is a vital intervention capable of rapidly restoring perfusion for patients in shock. Despite increasing use to provide circulatory support, its hemodynamic effects are poorly understood and the impact of patient-specific anatomical variation on perfusion is unknown. This study investigates the complex failing heart-mechanical circulatory support circulation and analyzes the effect of patient-specific vascular anatomical variations on hemodynamics and end-organ perfusion.
methodsPatient-specific vascular geometries were constructed from segmenting clinical computerized tomography angiography images and quantitatively compared using tortuosity, curvature, torsion, and lumen diameter. Computational fluid dynamic simulations were performed on a subset of geometries selected to represent a range of anatomical variation. Heart failure severity was modeled by varying the relative fraction of total flow provided by the heart and the extracorporeal circuit. A 3-element lumped parameter model was applied to accurately and dynamically model distal perfusion boundary conditions. Hemodynamic parameters and end-organ perfusion were analyzed and compared to assess the effect of anatomical variation.
resultsPulsatile antegrade cardiac perfusion and ECMO retrograde perfusion collide in the aorta to form a dynamic watershed region. The size, position, and variation of this region over the cardiac cycle is substantially altered by patient anatomical region. Increased vascular tortuosity reduces the proximal extent of flow from circulatory support and decreases the size of the watershed region.
conclusionsPatient vascular anatomy is a key determinant of the ECMO-failing heart circulation that alters the location and extent of the watershed region and affects the tissues at risk for differential hypoxia and circuit-derived thromboemboli for a given level of support.
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