Patel CB, Blue L, Cagliostro B, et al. - The randomized controlled trial (MOMENTUM 3) demonstrated the superiority of the HeartMate 3 (HM3) fully magnetically levitated centrifugal-flow left ventricular assist device (LVAD) over the HeartMate II (HMII) axial-flow LVAD. Researchers here sought to determine the clinical patterns of infection-related outcomes over 2 years of support via performing a trial-level analysis. In MOMENTUM 3, implantation with either the HM3 (n = 515) or HMII (n = 505) pump was done in 1,020 patients. At 2 years, the cumulative number of infections was 1,213 (634 HM3 and 579 HMII); 58% of patients with the HM3 and 56% of patients with the HMII experienced occurrence of major infection. Thus patients implanted with contemporary continuous-flow LVADs commonly experience infection as an adverse effect, with most such events unrelated to the pump or its peripheral components. To understand and ameliorate this morbidity, they suggest investigating the immunomodulatory role of chronic mechanical circulatory devices in predisposing to infection,