title: Pearls and pitfalls in managing right heart failure in cardiac surgery.
abstract: OBJECTIVE
  To review the recent insights in the evaluation and management of perioperative (RHF).
  
  
  RESULTS
  Recent studies highlight the potential role of myocardial deformation imaging in the evaluation of patients at risk of postoperative RHF. There is also a growing interest to study the value of load-adaptation indices of the right heart in the setting of pulmonary hypertension or left ventricular assist device implantation. Finally, the field of temporary extracorporeal life support devices for RHF is rapidly evolving and new strategies are emerging.
  
  
  CONCLUSIONS
  An integrated approach for assessing the cardiopulmonary axis combining imaging, hemodynamic and tissue perfusion monitoring is emerging, as particularly helpful in the field. Several developments in the field of temporary right heart support including the pumpless interventional lung assist membrane ventilator are offering new opportunities to support the right-heart pulmonary circulation. Future multicenter studies are needed to develop more effective preventive and therapeutic strategies for RHF.
authors.affiliation: aDepartment of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA bDepartment of Anesthesiology and Division of Critical Care, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada cDepartment of Thoracic Surgery, Marie Lannelongue Surgical Center, University of Paris-South, Paris, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Haddad
authors.forename: Mahsa
authors.initials: M
authors.lastname: Elmi-Sarabi
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.forename: Olaf
authors.initials: O
authors.lastname: Mercier
authors.forename: Andre Y
authors.initials: AY
authors.lastname: Denault
mesh_terms: D006348:Cardiac Surgical Procedures; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*