Mechanical cardiorespiratory support was born in 1953, courtesy of John Gibbons’ cardiopulmonary bypass machine. Since then, support for failing heart and lungs has progressed in many formats, both acute and long-term. The first implantable ventricular-assist device (VAD) was implanted by Liotta in 1963, and another soon after by Debakey. Extracorporeal membrane oxygenation (ECMO) grew equally from Gibbons’ oxygenator (with the first successful case report published in 1972) and Bob Bartlett’s procedures (with the success of baby Esperanza’s treatment in 1976), which he followed with the first randomised prospective study of 28 patients in the late 1970s.