Veno-Arterial extracorporeal membrane oxygenation (V-A ECMO) is an effective circulatory aid device, which has been increasingly used in extracorporeal life mechanical support for rescuing shock caused by various causes. However, it is generally agreed that V-A ECMO has significantly increased the left ventricular afterload of the supported heart during operation, resulting in limited aortic valve opening, increased intracardiac pressure, and A series of adverse outcomes of left ventricular dilation. If not duly assessment and intervention enough, the recovery of cardiac function is delayed. Based on the hemodynamic characteristics of V-A ECMO, we review the whole spectrum of Left ventricle unloading (LVU) combined with V-A ECMO reported to date.