To elaborate a little bit more: the first generation of LVADs were had large mechanical pumps and were huge -- they could only be implanted in people with a lar

To elaborate a little bit more: the first generation of LVADs were had large mechanical pumps and were huge -- they could only be implanted in people with a large chest cavity, excluding a large number of patients (especially women) from eligibility for their device. Current popular models are continuous flow rotors that are much smaller (enabling their use in almost anyone) and are non-pulsatile. However, there's been a big push to move towards pulsatile devices. This is mostly driven by mechanobiolgy studies that show that there is a difference in the cellular programs of cells that are exposed to a continuous shear force versus a pulsatile shear force. Accordingly, to more closely replicate the natural physiology of the heart, there has been a big push towards using pulsatile devices.