A large proportion of patients with HF have cognitive deficits, many in the visual-spatial/constructional (VSC) domain. LVAD therapy provides only small improvement in cognitive deficits. LVAD patients must perform self-care functions related to their devices; however, deficits in the VSC domain may affect LVAD specific duties, such as battery and driveline dressing changes. The purpose of this study was to see if patients with VSC domain deficits have more device related complications. Patients were recruited from clinic. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Trail Making Test form A and B were administered along with the Minnesota Living with Heart Failure Questionnaire to each patient. Demographic data and evidence of drive line infections; hospitalizations and death at baseline, 6 and 12 months intervals were collected from electronic medical record. 20 patients were enrolled (17 males), mean age of 62.25 years, mean education 14.1 years. 10% were impaired in immediate memory, 10% in delayed memory, 10% in attention, and 10% in total RBANS score. 35% were impaired in the VSC domain. There was no difference in number of baseline driveline infections, or incidence of new driveline infections, hospitalizations or death during the study period between VSC impaired and non-impaired groups. 40% of LVAD patients had significant impairment in at least one domain, 20% had impairment in more than one domain. We didn’t demonstrate a difference in driveline infections, hospitalizations or death between participants with VSC impairment and those without. While it is important that care providers be aware of cognitive deficits in patients presenting for LVAD implant, the presence of deficits need not limit their candidacy. Rather, creative strategies should be considered to assist such individuals achieve successful outcomes.