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Durable mechanical circulatory support with left ventricular assist devices (LVADs) have transformed the care of individuals with advanced heart failure. These devices have evolved given the substantial risk for adverse events associated with their use, including device thrombosis. The manufacturer-sponsored MOMENTUM-3 trial demonstrated the superiority of a fully magnetically levitated centrifugal-flow LVAD over an axial-flow device with respect to hemocompatibility outcomes (stroke, thrombosis, and bleeding; NEJM JW Cardiol May 2019 and N Engl J Med 2019; 380:1618). The current observational follow-up study documents outcomes in 477 of 536 individuals (median age, 62 years; 18% women) from MOMENTUM-3 still receiving LVAD support at two ye…