Assessment and treatment of the failing right heart: considerations for transplantation referral

Starr et al. (1) and Bakos (2) demonstrated in the 1940s that induced right ventricular (RV) myocardial necrosis in canines did not result in significant consequences on animal performance. Animals with surgically removed RV free wall could live a normal sedentary life (3). Thus, the RV has long been considered an accessory chamber needed only in cases of high RV afterload. This is until recent years when the true significance of RV function has been under spotlight, especially after advances in knowledge of the pathophysiology of pulmonary arterial hypertension (4)