Temporal Differences in Outcomes During Long-Term Mechanical Circulatory Support

•Placement indications for continuous-flow LVADs have changed.•Three distinct time periods corresponding to landmark changes in practice can be identified.•Despite differences, survivals are similar among time periods.•The most recent period is at an increased risk of gastrointestinal bleeding and pump thrombosis.•Temporal observations should help to develop targeted guidelines to improve outcomes. Device indications have changed for placement of continuous-flow left ventricular assist devices (CF-LVADs). We performed a multicenter analysis evaluating temporal variations in outcomes after CF-LVAD implantation. We retrospectively defined 3 time intervals to reflect changes in CF-LVAD technology (period 1, 2004–2009; period 2, 2010–2012; and period 3, 2012–2014). A total of 1,064 patients (Heartmate II [HMII] = 835; Heartware [HVAD] = 229) underwent CF-LVAD implantation from May 2004 to October 2014. Device utilization was different between periods: period 1: HMII = 134 (100%); period 2: HMII = 480 (88%) and HW = 63 (12%); and period 3: HMII = 221 (57%) and HW = 166 (43%); P