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VA-ECMO is recognized as a double-edged sword using the advantages of luxurious perfusion while offering an avenue when it comes to a deep failing heart to recoup, however with the issues of anticoagulation, inflammatory and bad systemic effects. Optimum effects after VA-ECMO are greatly reliant on a multitude of aspects and need a multi-disciplinary group to manage all of them. This informative article is designed to provide an insight into the pathophysiology of VA-ECMO, cannulatio