1. Hybrid Extracorporeal Membrane Oxygenation Using Avalon Elite Double Lumen Cannula Ensures Adequate Heart/Brain Oxygen Supply 
Ju Zhao, MD, Dongfang Wang, MD, PhD, Cherry Ballard-Croft, PhD, Jingkun Wang, BS, Po-Lin Hsu, PhD, Matthew Bacchetta, MD, Joseph B. Zwischenberger, MD 
The Annals of Thoracic Surgery 
Volume 104, Issue 3, Pages (September 2017)
DOI: /j.athoracsur
Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Hybrid extracorporeal membrane oxygenation (ECMO) circuit. The proposed hybrid ECMO circuit consists of an Avalon Elite double lumen cannula (DLC) in the superior vena cava, right atrium, and inferior vena cava; an arterial infusion cannula in the femoral artery; a CentriMag blood pump; and a gas exchanger. The Avalon Elite DLC drainage lumen withdraws venous blood from the superior vena cava and inferior vena cava to the pump-gas exchanger. Oxygenated ECMO blood is distributed into the femoral artery for venoarterial ECMO and into the right atrium through the DLC infusion lumen for venovenous ECMO.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Respiratory failure significantly decreased left ventricle (LV) blood oxygen saturation in venoarterial extracorporeal membrane oxygenation: (A) Po2; (B) o2 saturation. Abdominal aorta blood was obtained from a long catheter through the femoral artery. Left ventricle blood was obtained from a catheter through the left carotid artery. **p < (Black bars indicate normal lung; gray bars indicate compromising lung.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
In venoarterial extracorporeal membrane oxygenation with compromised lung, there was significantly lower blood oxygen level in the left ventricle (LV) (gray bars), whereas a very high blood oxygen level was present in the abdominal aorta (black bars), indicating differential hypoxia.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

5. Fig 4
At 0% venovenous (VV) blood flow (pure venoarterial extracorporeal membrane oxygenation [ECMO]), the oxygen content in pulmonary artery (triangles) and left ventricle (LV) (open circles) was very low compared with the oxygen content in the abdominal aorta (solid circles): (A) Po2; (B) o2 saturation. With increasing VV blood flow, the oxygen content in pulmonary artery and left ventricle rose proportionally. The abdominal aorta was perfused by saturated venoarterial ECMO blood, with oxygen content unaffected by VV blood flow.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions