This multicentre retrospective study evaluated the effectiveness of different microaxial flow pump (mAFP) devices—mainly Impella CP (3.5 L/min) and Impella 5+ (>5 L/min)—used to stabilize patients with severe heart failure before durable LVAD implantation. High-flow mAFPs were associated with improved hemodynamic support, reduced complications (e.g., renal/liver failure, RVAD use), and better mobilization, although 30-day mortality did not differ significantly between groups.