Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is increasingly used to treat refractory cardiogenic shock,1 despite randomized clinical trials reporting no difference in outcomes.2,3 Although traditional ECMO pumps maintain a constant flow by sustaining a consistent impeller rotation speed, innovative designs featuring alternating pump speeds to generate a pulsatile flow pattern have emerged. With several potential benefits reported, such as improved microvascular perfusion and indirect unloading,4 newer pumps aim to improve patient outcomes. Here, we aimed to investigate a novel pressure-sensitive volume displacement pulsatile V-A ECMO device using a validated mock-circulation loop (MCL).5