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In V-VA ECMO and the Impella (v-ECPELLA), we attempted weaning from VA ECMO by only clamping VA cannulation and switching to veno-venous ECMO. We restored the setting to VA ECMO after assessment of the systemic circulation. We successfully managed and weaned our patient from simultaneous use of VA ECMO and the Impella2.5 by using v-ECPELLA. .A 69-year-old woman with previous pancreaticoduodenectomy was admitted for evaluation of chest discomfort on effort and leg edema for a few months. Oral flosemide before admission for 1 week failed

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