In patients with advanced heart failure, the use of a fully magnetically levitated, centrifugal-flow left ventricular assist device (LVAD; HeartMate 3, Abbott) is associated with a reduced rate of disabling stroke and reoperation to replace or remove a malfunctioning device compared with the use of an axial-flow device (HeartMate 2, Abbott). This finding comes from the MOMENTUM 3 trial presented at ACC.19. In two previous interim analyses, the HeartMate 3 device was associated with a reduced rate of pump thrombosis or nondisabling stroke. The final analysis included a total of 1,028 patients who were randomly assigned to receive the HeartMate 3 or the HeartMate 2 device. The rate of survival free from disabling stroke and reoperation to replace or remove a malfunctioning device (the primary end point) was 76.9% and 64.8% in each group, respectively (relative risk (RR) 0.84, 95% CI 0.78–0.91, P < 0.001 for superiority). Pump replacement (the principal secondary end point) was also less common with the HeartMate 3 than with the HeartMate 2 device (RR 0.21, 95% CI 0.11–0.38, P < 0.001).