Pump Thrombosis: A Limitation of Contemporary Left Ventricular Assist Devices

For the majority of patients with heart failure (HF) the management is non-surgical, but for the most advanced subgroup of patients with heart failure and reduced ejection fraction, mechanical circulatory support (MCS) is becoming a more viable treatment option. Heart transplantation is the 'gold standard' for advanced HF therapy, but is limited by donor organ availability. In contrast, MCS utilization has risen exponentially over the past decade. Pump thrombosis is a rare but increasingly recognized cause of morbidity and mortality in this population. In this review, we define the problem of pump thrombosis, discuss diagnostic testing and approaches to the prevention and management of this potentially devastating complication of durable MCS.