The outcomes were compared to the most likely outcome of the management that would have been used in the absence of Impella. [...] The clinical records of the first 8 patients managed with the Impella® device at the MUHC over the past year were reviewed to determine the role that Impella® had played in their outcome, and the costs incurred. [...] The outcome of interest was that in the absence of Impella® use 8/23 (35%) patients. [...] These outcomes are, of course, very dependent on the selection of cases 12 MUHC Experience Of the eight cases in which Impella® was used at the MUHC during the past year, two were prophylactic (support of severely compromised circulations during performance of a PCI and a cholecystectomy, respectively) and 6 were used in a rescue situation. [...] Below, we summarise each case and compare the outcome and cost of Impella® use to an estimate of what the outcome and cost would have been in the absence of Impella® use.