What are VA neoECMO cannulation sites?

• A. Right Internal Jugular and Right Carotid
• B. Left Internal Jugular and Left Carotid
• C. Right Femoral Vein and Right Carotid
• D. Left Subclavian and Left Carotid

Answer: (B)

In VA ECMO for neonates, blood is drained from the venous system and returned into the arterial system to support both circulation and oxygenation. The neck vessels are a common and practical access route because they give direct central access with manageable cannula length and flow. A typical neonatal setup uses a venous drainage cannula in the internal jugular vein to reach the right atrium, and an arterial return cannula in the carotid artery to deliver oxygenated blood into the systemic circulation. Selecting the left-sided pair means placing the drainage cannula in the left internal jugular vein and the arterial return cannula in the left carotid artery. This configuration is chosen based on anatomy and surgical exposure, and it aligns with preserving other vessels while achieving effective central perfusion. Other configurations, such as femoral access, are more common in older patients, but they are not the standard neonatal neck approach described here.