The purpose of this study was to test the pump performance of a miniaturized, newly developed, implantable rotary blood pump (the diagonal pump). In a series of six sheep, the pump was interposed in an atrial-aortic connection. Heart failure was induced by serial injection of glass beads into the left coronary artery. The assistance of the non-failing heart (with pump output up to 4.5 liter/min) did not change the total cardiac output or the blood pressure of the animal. The heart was significantly unloaded as demonstrated by a drop in first derivative of the left ventricular pressure (dP/dt) max (from 1645 to 1113 mmHg/s; P = 0.0003). Because of the specific interaction between heart function and rotary blood pump performance, the pump provided considerably more flow in the failing than in the non-failing heart. Cardiac output and perfusion pressures were restored to pre-assist values in the failing heart model. The heart-rotary blood pump interaction is an ideal substrate for long-term assistance. With this miniaturized rotary blood pump, hemodynamics in a severely failing heart can be restored. Atrial cannulation, which leaves the left ventricle untouched, provides similar results as apical cannulation in the failing heart.