This study is testing the Impella BTR™, a small pump that helps the heart in people with serious heart failure. The pump is placed through surgery and helps blood flow from the heart to the rest of the body. The study checks if the pump is safe and if it works well for up to 28 days. People in the study will be watched for 90 days after surgery to see how they do. To join, you must be at least 18 years old and already have severe heart failure. You should not have certain other heart problems or other health issues that make surgery risky.

• The study lasts for 3 months (90 days).
• Participants will have a surgical procedure to place the pump.
• All side effects will be recorded until the study ends.

Before you join, doctors will explain everything, and you'll need to agree (sign a consent) to participate. If you have any health problems listed in the exclusion criteria, you cannot join. This study is only for adults with severe heart failure who need more help than medicine can provide.