Progression of the optimal design as determined by the FSI-based SMF optimization scheme. The optimization cost function value, which is derived from particle residence time in the blood chamber, is displayed under each model. The strong inclination toward vertically oriented arms is reasonable, as this configuration enables the incoming blood to move more quickly and uniformly toward the outlet than other designs. However, the idea to vertically mount the inlet/outlet arms is non-intuitive, a result that reinforces the value and importance of systematic design space optimization for PVADs. See [171] for more details.