The authors present the successful use of the Impella recover 100 intracardiac left ventricular assist device in a 55-year old man suffering from end-stage ischemic cardiomyopathy. The pump was implanted preoff pump coronary artery bypass grafting (OPCAB) and it was successfully weaned 5 days postoperatively. In addition, an intra-aortic balloon pump (IABP) was implanted to convert the non-pulsatile flow of the Impella into a pulsatile flow. In this paper benefits and risks of this technique are shown.