ArticleJTCVS open2025
Flow benefits of pediatric arterial cannulae versus introducer sheaths as distal perfusion catheters in venoarterial extracorporeal membrane oxygenation.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Flow Matters: Distal Limb Perfusion in Extracorporeal Membrane Oxygenation.JACC. Case reports · 2026Article
- Novel Use of a Distal Perfusion Catheter With a Removable Side Port in Patients on VA-ECMO.JACC. Case reports · 2026Article
- Retrograde perfusion of the dorsalis pedis artery versus traditional distal perfusion catheter use in venoarterial extracorporeal membrane oxygenation.JTCVS open · 2026Article
- Modifying a traditional femoral venoarterial extracorporeal membrane oxygenation cannulation strategy and circuit to improve distal limb hemodynamics.JTCVS open · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: We test the hypothesis that pediatric arterial ("peds art") cannulae as distal perfusion catheters (DPCs) for venoarterial extracorporeal membrane oxygenation provide more favorable distal limb hemodynamics than introducer sheaths. Methods: Introducer sheaths (Teleflex 5, 6, 8 Fr) and peds art cannulae (Medtronic 6, 8, 10 Fr) were tested as DPCs in static and dynamic mock loops. Flow through each and flow loss caused by their intravascular obstructiveness was measured to calculate pressure gradient versus flow, intravascular obstruction flow, and resistances. Results: All 3 peds art cannulae tested delivered greater flows than the 3 introducer sheaths. The 10-Fr peds art cannula provided the most flow (0.97 L/min, 1500 rpm), whereas all 3 introducer sheaths provided much lower and nearly identical flows (only 0.18-0.20 L/min, 1500 rpm) despite their different diameters. The 10-Fr peds art cannula provided the most flow at equivalent head pressures despite being the most obstructive (least amount of flow around it, 2.0 L/min) relative to no DPC (2.5 L/min), resulting in the highest cumulative flow distally. Conclusions: The 10-Fr peds art cannula was the most beneficial DPC tested. All peds art cannulae tested possessed a better tradeoff of flow delivery versus intravascular obstructiveness compared to introducer sheaths, resulting in more favorable distal limb hemodynamics. The integrated stopcock with small holes (0.061'' = 4.65 Fr) on the introducer sheath's sidearm and at the 90° sidearm's attachment to the sheath's hub increase resistance. These chokepoints of introducer sheaths prevent sufficient flow to support distal limb perfusion as DPC.
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