We utilized a new ventricular assist device, the PulseCath catheter, to perform an off-pump bypass procedure in a patient with low ejection fraction. The 21 Fr PulseCath catheter, driven by a standard intra-aortic balloon pump console, can generate a pulsatile flow of 2-3 l/min. The PulseCath coupled with an intra-aortic balloon pump device is an important tool for left ventricular assistance.