Echocardiographic evidence of right ventricular remodeling after transplantation

Right ventricular (RV) failure is a significant source of mortality after cardiac transplantation. The use of RV assist devices (RVAD) as a bridge to recovery has been reported. However, early changes of RV structure and anatomy after RVAD implantation have yet to be described. We report a case of RV failure after transplantation requiring RVAD implantation. After 3 weeks of gradual weaning of inotropic and RVAD support, the device was explanted successfully. Transesophageal echocardiography documents RV hypertrophy and remodeling between RVAD implantation and removal, suggesting a rapid adaptive response of the right ventricle in the presence of pulmonary hypertension.