V-A, or veno-arterial ECMO, supports both heart and lung function. The surgeon will place two cannulae, one in a large vein and one in a large artery so that blood can be taken out of a vein and returned into an artery. V-A ECMO is most like the heart-lung machine used during heart surgeries.
V-V or veno-venous ECMO, supports lung function primarily. The surgeon will place the cannulae in a large vein only, usually in the neck. Based on the patient’s age and condition, the surgeon may choose to place one special cannula in a single vein or place two cannulae in two different veins. The special cannula in one vein has two channels, side by side, allowing the ECMO pump to draw blood out through one channel and back in through the other.
Variation in V-V ECMO cannulae sites
Sometimes with older children and adults, the surgeon may place more than two cannulae or place the cannulae in veins in the lower extremeties.
Central cannulation for V-A ECMO
Central cannulation for V-A ECMO is one approach used for neonates and small children. Central cannulation is through an open chest with cannulae directly placed into the arch and right atrium.