Inclusion Criteria:  Informed consent signed and dated by study patient/legal representative and investigator/authorised physician Minimum age of 18 years Patients in cardiogenic shock  Cardiogenic shock is defined as:  Systolic blood pressure < 90 mmHg for at least 30 min Inotropes and/or vasopressors are needed to maintain systolic blood pressure > 90 mmHg Clinical signs of heart insufficiency with pulmonary congestion  Signs of end organ hypoperfusion with at least one of the following criteria:  Cold, damp skin or extremities Oliguria (≤ 30 mL/h) Serum lactate > 3.0 mmol/L  Exclusion Criteria:  In case of female patients: pregnancy or lactation period Participation in an interventional clinical study during the preceding 30 days Previous participation in the same study Age > 85 years Cardiac arrest out of hospital with return of spontaneous circulation (ROSC) > 30 min No flow time > 5 min Mechanical causes for cardiogenic shock (ventricular septal defect of papillary muscle rupture) Non-cardiogenic causes of shock (bradycardia, sepsis, hypovolemia, etc.) Fever (Body temperature > 38.0 °C) or other evidence of sepsis Onset of cardiogenic shock > 6 h before enrolment Lactate > 16 mmol/L Severe peripheral arterial occlusive disease precluding insertion of femoral arterial or venous catheters Contra-indications for anticoagulation Contra-indication for VA ECMO, e.g. unrecoverable heart and not a candidate for transplant or VAD