439 © Springer Science+Business Media New York 2015 N.F. Voelkel, D. Schranz (eds.), The Right Ventricle in Health and Disease, Respiratory Medicine, DOI 10.1007/978-1-4939-1065-6_21 Chapter 21 Right Ventricular Assist Devices Lynn R. Punnoose, Marc A. Simon, Daniel Burkhoff, and Evelyn M. Horn Introduction Acute decompensated right heart failure (ADRFH) often proves refractory to medi- cal therapy that includes measures such as pulmonary vasodilators, systemic vaso- pressors, and inotropes (see also Chap. 10) oxygen therapy and (where appropriate) balloon atrial septostomy. In this chapter, we will discuss the use of mechanical circulatory support devices (MCSD) to sustain the failing right ventricle (RV). We will focus in particular on the role of extracorporeal life support (ECLS) and inno- vative device therapies in patients with pulmonary hypertension (PH), most of whom are candidates for bridge to transplant (and occasionally bridge to recovery) strategies. L.R. Punnoose, M.D. (*) Department of Cardiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Scaife Hall, Pittsburgh, PA 15213, USA e-mail: punnoosl@alum.mit.edu; punnoosel2@upmc.edu M.A. Simon, M.D., M.S. Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Scaife Hall, Pittsburgh, PA 15213, USA e-mail: simonma@upmc.edu D. Burkhoff, M.D., Ph.D. Department of Medicine, Columbia University, 177 Fort Washington Avenue, New York, NY 10032, USA e-mail: db59@columbia.edu E.M. Horn, M.D. Department of Medicine/Division of Cardiology, Weill Cornell Medical College of Cornell University, 520 East 70th Street, ST-443, New York, NY 10021, USA e-mail: horneve@med.cornell.edu