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The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build\u2010up when low\u2010flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop in flow and pumping power leading to failure of the LVAD, if left unattended. If a clot becomes dislodged and circulates in the bloodstream, it may disturb the flow or occlude the blood vessels in vital organs and cause internal damage that could be fatal, for example, ischemic stroke. That is why patients with LVADs are on anti\u2010coagulant medication. However, the anti\u2010coagulants can cause a set of issues for the patient\u2014an example of gastrointestinal (GI) bleeding is given in illustration. On account of this, these devices are only used as a last resort in clinical practice. It is, therefore, necessary to develop devices with better mechanics of blood flow, performance and hemocompatibility. This paper discusses the development of LVADs through landmark clinical trials in detail and describes the evolution of device design to reduce the risk of pump thrombosis and achieve better hemocompatibility. Whilst driveline infection, right heart failure and arrhythmias have been recognised as LVAD\u2010related complications, this paper focuses on complications related to pump thrombosis, especially blood coagulopathy in detail and potential strategies to mitigate this complication. Furthermore, it also discusses the LVAD implantation techniques and their anatomical challenges.<\/jats:p>","DOI":"10.1111\/joa.13675","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T06:25:28Z","timestamp":1650522328000},"page":"29-49","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Advancements in left ventricular assist devices to prevent pump thrombosis and blood coagulopathy"],"prefix":"10.1111","volume":"242","author":[{"given":"Grainne","family":"Malone","sequence":"first","affiliation":[{"name":"Tissue Engineering Research Group (TERG) Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin 2  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerges","family":"Abdelsayed","sequence":"additional","affiliation":[{"name":"School of Medicine RCSI University of Medicine and Health Sciences, 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