Temporary circulatory support (TCS) have become the cornerstone of the management of patients with cardiogenic shock, although the evidence supporting their efficacy is limited.

VA-ECMO is considered the first-line option, with a growing number of accepted and emerging indications.

Randomized clinical trials are now needed to determine the place VA-ECMO in cardiogenic shock treatment strategies.

VA-ECMO is utilized as a bridge to “decision” that includes weaning after cardiac function recovery, transplantation, long-term mechanical circulatory support, and withdrawal in case of futility.

VA-ECMO is considered the first-line TCS as it allows rapid improvement in oxygenation, is less expensive, and is also suitable for patients with biventricular failure.

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