Many cardiac diseases, like coronary artery disease and some viral cardiomyopathy over a period of time, give rise to the condition called heart failure (HF). More than 2 million Indians suffer from HF today. The first line of management includes lifestyle modifications, as well as medical therapy. The latter uses drugs such as beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptors/blockers aldosterone antagonists, diuretics, digoxin, and many others keep getting added with more research and research and development today. Salt and fluid restriction too plays a pivotal role. Patients with a wide QRS complex in their electrocardiogram and those having a moderate to severe symptoms of HF need to have a cardiac resynchronization therapy and a patient with fatal arrhythmias needs an implantable defibrillator inserted as therapy. So, use of advanced mechanical therapies is a necessity in HF patient.

• Integrated ECMO circuitry was established along with CPB circuit and primed with blood

• Advantages of integrated circuit of them:

 1. No time is lost from decision to initiation of ECMO

 2. Early Initiation may prevent end organ damage

 3. With a use of integrated ECMO, surgical asepsis is maintained

 4. The procedure is cost-effective

 5. Increasing survival in these critically ill patients

Abbreviations: CPB, cardiopulmonary bypass; ECMO, extracorporeal membrane oxygenation.