Purpose of the study was to evaluate the effectiveness of the use of the еxtracorporeal membrane oxygenation (ECMO) procedure in patients with acute heart failure after heart surgery with cardiopulmonary bypass. Materials and methods . Venoarterial ECMO for the treatment of critical acute heart failure was used in 16 adult patients. There were 10 men and 6 women, with mean age at 61,5±9,8 years. The indication for ECMO in all cases was acute heart failure, with the ineffectiveness of drug therapy. In 5 (31,3%) patients, ECMO was started intraoperatively in 5 (31,3%) patients, ECMO was started in the ICU in 12 hours after the operation, and in 6 (37,5%) patients – more than 24 hours after the end of operation. 2 groups of patients were formed: the first group (10 patients) included patients in which ECMO could stabilize patients condition, and the ECMO procedure was completed; in the second (6 patients) – patients who died during ECMO. Evaluation was carried out on the basis of clinical, functional and biochemical criteria. Results . Cardiac index significantly increased (by 11,3%) 12 hours after the start of ECMO, and after 48 hours it reached a normal value in the 1st group, which was accompanied by a significant increase in ejection fraction of the left ventricle (to 47,3±7,4%), a decrease in inotropic score (up to 11,9±7,8) and an increase in oxygen supply (up to 775±36 ml/min), in the absence of positive dynamics of these indicators in the 2nd group. Survival rate after the procedure was 62,5%, the discharged patients rate was 37,5%. Conclusion . The use of venoarterial ECMO procedure in the complex treatment of patients with critical acute heart failure after cardiac surgery allows achieving satisfactory survival rates and discharge from the hospital with the development of a potentially fatal complication.