A heart pump is disclosed herein. The heart pump can include a cannula having one or more outlets. An impeller can be positioned in the cannula. The impeller can be configured to pump blood through the outlets along a longitudinal axis when the impeller is rotated at an operational speed. The heart pump can be configured to adjust an effective area of the outlets while the impeller is rotating or to provide relative motion between the cannula and the impeller along the longitudinal axis while the impeller is rotating.