Fluid dynamic analysis of turbodynamic blood pumps (TBPs) is often conducted under steady flow conditions. However, the preponderance of clinical applications for ventricular assistance involves unsteady, pulsatile flow-due to the residual contractility of the native heart. This study was undertaken to demonstrate the importance of pulsatility and the associated time derivative of the flow rate (dQ/dt) on hemodynamics within a clinical-scale TBP. This was accomplished by performing flow visualization studies on a transparent model of a centrifugal TBP interposed within a cardiovascular simulator with controllable heart rate and stroke volume. Particle image velocimetry triggered to both the rotation angle of the impeller and phase of the cardiac cycle was used to quantify the velocity field in the outlet volute and in between the impeller blades for 16 phases of the cardiac cycle. Comparison of the unsteady flow fields to corresponding steady conditions at the same (instantaneous) flow rates revealed marked differences. In particular, deceleration of flow was found to promote separation within the outlet diffuser, while acceleration served to stabilize the velocity field. The notable differences between the acceleration and deceleration phases illustrated the prominence of inertial fluid forces. These studies emphasize the importance of dQ/dt as an independent variable for thorough preclinical validation of TBPs intended for use as a ventricular assist device.</p