Comparison of continuous-flow and pulsatile-flow left ventricular assist devices: is there an advantage to pulsatility?

This publication by the University of Louisville group provides an excellent comparative analysis of the outcomes after continuous-flow (CF) vs. pulsatile flow (PF) LVADs.  Although the outcomes after CF LVAD implantation are clearly superior than those of PF LVADs, there are certainly unique morbidities after CF LVAD implantation.  The authors argue that these differential outcomes beg the question:  Should pulsatility algorithms be introduced in all contemporary CF LVADs?