Ed Soltesz, MD, MPH, from the Cleveland Clinic, moderates this informative series of case presentations highlighting Impella 5.5® with SmartAssist® in cardiac surgery. Marisa Cevasco, MD, MPH, presents a case in which she used Impella 5.5 for high-risk cardiac surgery in a patient at risk for low cardiac output syndrome (LCOS). Shams Khwaja, MD, presents a case illustrating Impella 5.5 assisted high-risk valve surgery. Jerome Crowley, MD, MPH, presents cases illustrating early identification and management of RV failure.