The Bivacor pump does have a pulse-like output, so I suspect some of the issues with earlier rotary pumps might not be so prevalent. Because it's a rotary pump though I suspect there's still issues with cell damage as they pass parts of the rotating assembly. The video claims that wide clearances reduce the risks of clotting from cell damage, but it's a reduction - not outright removal. See around the 3:40 to 4 minute mark on the video at https://www.bivacor.com/