Extracorporeal life support (ECLS)/extracorporeal membrane oxygenation (ECMO) is a powerful tool in the surgeon's armamentarium. The rapid evolution of ECLS over the last four decades has improved survival in patients with cardiopulmonary failure. With the pandemic outbreak of H1N1 in 2009 and onward, the application of ECLS has only risen. Yet, amongst the outcomes reporting and improved survival, the water remains hazy in terms of outcome predictors as well as discovery of the "ideal" system. There remains much room for innovation and research related to circuit construction, ideal flow, myocardial recovery, and additional applications of ECLS. We present a review on the topic of veno-arterial extracorporeal membrane oxygenation (VA-ECMO).
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