The issue of extracorporeal membrane oxygenation in patients with complex congenital heart disease is indispensable for discussing ECMO in the pediatric population. Although a clear consensus is lacking on the proper indication of ECMO in this population, induction of ECMO should be considered earlier when hemodynamics are unstable to avoid circulatory collapse. Hemorrhagic complication is not rare and should be treated with supplemental treatment according to its etiology. Aggressive systemic

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... entricle decompression should be considered for better and earlier systemic ventricle functional recovery. Better ECMO management in patients with characteristic single ventricle of complex congenital heart disease requires a better understanding of the unique physiology of patients with single ventricle, and ECMO management specific to the physiology of each patient is required.