Clear clinical guidelines for the assessment and treatment of right ventricular failure (RVF) remain an unmet need. Although high complexity patients are common in this setting, the ideal management remains uncertain, resulting in high mortality rates despite presumably optimal medical therapy. Timely treatment with Impella RP may offer benefits by supplying circulatory support during the acute RVF phase and providing the time and unloading necessary for native right heart recovery. As such, mastering the technicalities and ancillary therapies is crucial to best utilize this salvage opportunity, particularly in these high complexity patients. Here, we report three different clinical scenarios of medically refractory RVF supported with Impella RP to provide examples and discuss the contribution of mechanical RV support to patient outcomes.

中文翻译：

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时机、定位和辅助治疗：成功的 Impella RP 的三要素。

评估和治疗右心室衰竭（RVF）的明确临床指南仍然是一个未得到满足的需求。尽管高复杂性患者在这种情况下很常见，但理想的治疗仍然不确定，尽管可能有最佳的药物治疗，但仍导致高死亡率。及时使用 Impella RP 治疗可能会带来好处，可以在急性 RVF 阶段提供循环支持，并为自然右心恢复提供必要的时间和卸载。因此，掌握技术细节和辅助疗法对于最好地利用这一挽救机会至关重要，特别是对于这些高度复杂的患者。在这里，我们报告了 Impella RP 支持的医学难治性 RVF 的三种不同临床情况，以提供示例并讨论机械 RV 支持对患者预后的贡献。