The right prediction.

Despite much improvement in the outcomes of patients undergoing implantation with left ventricular assist devices (LVADs), right ventricle (RV) failure remains a challenging clinical dilemma, particularly perioperatively as a significant cause of morbidity and mortality (1). In the patient freshly implanted with an LVAD, the RV becomes the limiting step to increase forward cardiac output. With increasing right atrial pressures in a failing RV, along with poor forward flow and, thereby, blood pressure, organ perfusion is compromised, leading to multiple organ dysfunction. Accordingly, many clinical investigators who work in this area have attempted to assess RV function pre-operatively, so as to either better select appropriate candidates for LVAD support, mitigate the impact of poor RV function post-operatively, or allow planning for interventions such as RV assist devices.