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. 2022 Nov 4;9:1045601. doi: 10.3389/fcvm.2022.1045601

FIGURE 2.

FIGURE 2

(A–C) Diagram on configurations of percutaneous mechanical circulatory support devices. (A) Peripheral VA ECMO. Poorly oxygenated blood is drawn from the femoral vein, oxygenated in a membrane oxygenator and returned by a centrifugal pump via the common femoral artery. (B) VA ECMO and Impella® pump (“ECMELLA”). The Impella® pump is placed across the aortic valve to provide continuous blood flow from the LV into the proximal ascending aorta. (C) VAV ECMO and Impella®. VAV ECMO is a triple cannulation technique by “upgrading” the VA ECMO configuration. A third cannula is inserted into the jugular or subclavian vein. The ECMO outflow with oxygenated blood is diverted into two cannulas by a Y-connector, one cannula toward the aorta via the common femoral artery and one toward the right atrium via the jugular or subclavian vein. Flow regulators control blood flow into the arterial and venous circuit, respectively. Abbreviations: left ventricle (LV); veno-arterial extracorporeal membrane oxygenation (VA ECMO); veno-arterio-venous ECMO (VAV ECMO).