The procedure involves the insertion of cannulas into large blood vessels, usually the right atrium (via the femoral or internal jugular vein) for venous access and the aorta (via the carotid or femoral artery) for arterial access. Blood is drained from the venous system, passed through an oxygenator in the ECMO circuit, and then pumped back into the arterial system. This allows the heart and lungs to rest and recover while ensuring adequate oxygen delivery to vital organs.