Minimally invasive management of central ECMO after ascending aortic surgery.

A small percentage of ascending aortic surgical procedures require temporary mechanical circulatory support, of which veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is the most established technique. We present a surgical technique for minimally invasive central V-A ECMO management, avoiding resternotomy or ventricular compression, while maintaining antegrade blood flow and permitting sternal closure following ascending aortic surgery.