Table 1. Diagnostic criteria for RVF and severity score of RVF.

Diagnostic criteria for RV failure:

Symptoms and signs of persistent right ventricular dysfunction, CVP >18 mmHg with a CI <2.0 L/min/m2;

In the absence of elevated left atrial/pulmonary capillary wedge pressure >18 mmHg, tamponade, ventricular arrhythmias or pneumothorax;

Requiring RVAD implantation; or requiring inhaled nitric oxide or inotropic therapy for duration of more than one week at any time after LVAD implantation.

Severity scale:

Severe: RVAD implantation;

Moderate: inotropes or use of IV or inhaled pulmonary vasodilator (iNO or prostaglandin E);

Mild: 2 of the 4 following criteria:

CVP >18 mmHg or mean RA pressure >18 mmHg;

CI <2.3 L/min/m2 (using a pulmonary artery catheter);

Ascites or evidence of moderate to worse peripheral oedema;

Evidence of elevated CVP by echocardiogram (dilated inferior vena cava without collapse), and in physical exam (signs of increased jugular venous pressure).

Abbreviations: RVF, right ventricular failure; RV, right ventricle; CVP, central venous pressure; CI, cardiac index; RVAD, right ventricular assist device; LVAD, left ventricular assist device.