Pump thrombosis—A riddle wrapped in a mystery inside an enigma

This manuscript reviews the state of the art regarding the subject of pump thrombosis (PT). The historical context of PT and the clinical data are described, the etiologic factors are elucidated, preventive strategies are explored, diagnostic modalities are reviewed, and management principles are defined. There clearly remains much work to be done towards solving this riddle wrapped in a mystery inside an enigma, but promising foundations are being established.