Left ventricular assist devices (LVADs) are being used widely to support patients with advanced systolic heart failure. Some of these patients will need more than one LVAD replacement due to pump thrombosis. The Heartmate III LVAD (Abbott Inc, Chicago, IL) recently has been shown to have a very low incidence of pump thrombosis. In this article, we describe cases of patients with multiple pump thrombosis events, who were successfully replaced with the Heartmate III.