We describe a novel axillary approach for insertion and usage of the Impella LP5.0, a low cost micro-axial flow pump, in five patients requiring circulatory support after acute ST-segment elevation myocardial infarction (STEMI). This alternative approach for implantation of the Impella LP5.0 has been proven simple, safe and feasible, and less invasive in severely compromised patients. Our hybrid, percutaneous and surgical, approach offered acute short-term circulatory support in STEMI patients with acute heart failure, allowing myocardial recovery or selection for long-term mechanical support.