Background: The Cancion® Cardiac Recovery System (CRS) is a novel, percutaneous, low flow circuit, superimposing non-pulsatile flow in the descending aorta. This abstract reports the impact of this device on cardiac hemodynamics in 23 patients. Methods: Entry criteria included: 1) recently exacerbated chronic heart failure (CHF); 2) sustained (>24hr) elevated PCWP despite IV inotropes; 3) reduced creatinine clearance and/or diuretic resistance. Inflow to the miniature centrifugal pump was via percutaneous femoral artery cannula, and outflow was via percutaneous aortic pigtail cannula (n=19) or axillary graft cannula (n=4). Cath lab insertion was<30 minutes. Hemodynamics were measured at baseline, every 8 hrs on device, and 12 and 24 hrs post device removal. Results: CRS was placed in 23 patients. Mean age was 55 (26–75) yrs. Patients were supported for an average of 73 (24–112) hrs. Pump flows averaged 1.33 (1.2–1.5) l/min. Mean PCWP decreased from 28±5 to 22±9 mmHg at 24 hrs and 20±7 mmHg at 72 hrs post-implant (both p<0.005). Mean Cardiac Index (CI) was 1.97±0.46 and 2.06±0.39 l/min/m2 at baseline and 24 hrs, and increased to 2.24±0.45 l/min/m2 72 hrs post implant (p<0.05). 24 hrs post-removal, hemodynamic benefit was sustained: PCWP 21±7 mmHg; CI 2.32±0.47 l/min/m2 (both p<0.0001 vs. baseline) representing marked, sustained favorable shift in the Starling relation. (See Figure.) By day 4 post-implant cumulative input-output averaged -3.5L and weight loss averaged 2.2 (0–7.5) Kg. Conclusion: The Cancion® CRS, a novel form of cardiac assist, acting through a low-flow, continuous aortic flow loop, induced progressive improvement in hemodyanamics, with both improved cardiac performance (shift in Starling relation) and negative fluid balance, in patients with exacerbated CHF. CRS, undergoing prospective, randomized, long-term investigation, represents a promising therapy for patients refractory to, or dependent on, IV inotropes.