Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) may provide adequate blood flow and perfusion in postcardiotomy cardiogenic shock patients. This article discusses patient assessment and management with anticoagulation, sedation, ventilation, and nutrition. Complications may occur, including bleeding, hemolysis, infection, acute kidney injury, stroke, left ventricular distention, limb ischemia, and upper body hypoxia. Patients may recover enough myocardial function to be weaned from ECMO or may be transitioned to a ventricular assist device or transplant. Quality of life may be affected by VA ECMO but may be no different than patients with other chronic health issues.