**2. Indications**

Interventional cardiology procedures, both for valvular and coronary diseases, have become increasingly complex in recent years. Patients to be treated often have multiple comorbidities that make cardiac surgery impractical because it is of very high risk. The development of new technologies has made it possible to treat patients who, until a few years ago, were destined only for palliative medical therapy. The need to treat these patients considered inoperable, he pushed the haemodynamist to use an "extracorporeal circulation" also in the haemodynamic room, in order to carry out very complex procedures both from a clinical and technical point of view in "safety." The literature shows how ECMO or in any case an extracorporeal circulation installed in an emergency regime is burdened by very high mortality and morbidity, especially in patients who have a reduced cardiac and respiratory reserve, where prolonged hypotension can rapidly evolve towards cardio-metabolic shock [1–4]. Veno-arterial extracorporeal membrane oxygenation (ECMO), therefore, initially conceived as a rescue therapy in emergencies and cardiogenic shock has become a "protection" tool for patients and operators [5–9]. The procedures that can be performed with the aid of extracorporeal assistance are many and can be performed individually or combined with each other, including TAVI [10–14], mitral valve [15–17] or percutaneous tricuspid repair, percutaneous coronary intervention [18–23], and electrophysiology procedures, such as ablations of ventricular tachycardias [24–26].
