Follow-Up Brain MRI After Carotid Reconstruction or Ligation in Neonatal Venoarterial Extracorporeal Membrane Oxygenation: Single-Center Retrospective Cohort, 2009–2022

In our neonatal VA-ECMO series from 2009 to 2022, follow-up brain MRI shows a high frequency of abnormalities or lesions. Overall, we failed to identify an association between decannulation strategy (i.e., carotid ligation or reconstruction) and proportion with ischemic findings. However, there appears to be an association between carotid reconstruction and higher-grade IVH. Further studies are needed to help with decision-making at the time of decannulation, to discern the mechanisms underlying the radiographic differences we identified in our series, and to investigate the connection between structural changes and long-term neurocognitive outcomes.