Background Extracorporeal membrane oxygenation (ECMO) for post-cardiotomy heart failure in neonates and infants still carries high mortality and morbidity rates. In this study we present the first European clinical experience with the Medos DeltaStream DP1, a new pulsatile flow pump, in neonates and infants. Methods The DP1 is an extracorporeal rotary blood pump. The pump features a diagonal flow impeller, and can be used for both continuous and pulsatile output. Special characteristics include its small priming volume of approximately 30 ml and a high pumping capacity. A temperature sensor and speed sensors are integrated into the pump. The pump has a delivery rate of up to 8 liters/min and a speed range of 100 to 10,000 rpm. Results Two patients being assisted with the pulsatile pump system were successfully weaned after 36 and 53 hours, respectively. Conclusions Based on our limited experience with 2 patients, we believe that pulsatile DP1 device is a reasonable alternative to current conventional non-pulsatile systems.