Ever since the adoption of the newest heart allocation system in the Fall of 2018, clinicians have grappled with the safest method of utilizing temporary mechanical circulatory support to get patients successfully to transplantation. In unique patients that do not have a durable left ventricular assist device as a therapeutic option and have not had a full work-up for transplantation consideration, the establishment of ambulatory extracorporeal membrane oxygenation is an attractive solution.