Right Ventricular Failure and Biventricular Support Strategies.

Some degree of right ventricular (RV) dysfunction can be observed in most patients with advanced heart failure assed for left ventricular assist device (LVAD) implantation. This article describes critical factors that need to be considered in the assessment of the RV before LVAD surgery. Further, detailed description of the most important perioperative management strategies to prevent (RV) dysfunction is included. Finally, the most commonly used temporary and permeant RV support strategies are discussed, including anatomic and physiologic challenges and barriers associated with the off-label use of continuous-flow LVAD pumps for the right-sided circulation.