Owing to the growing demands of extracorporeal membrane oxygenation (ECMO)-designated support required for severe cardiac or respiratory failure, which is both potentially reversible and unresponsive to conventional management, novel ECMO indications emerge day after day. ECMO offers unique advantageous characteristics, which are compact pump-oxygenator design, percutaneous approach, flexible cannulae, and less inflammation making the modern venoarterial ECMO an ideal miniaturized cardiopulmonary bypass. We hereby discuss the background of ECMO success to backup complex high-risk cardiac surgical procedures.