Right ventricular failure may complicate isolated left ventricular ass
istance. In a series of 8 patients undergoing left ventricular assista
nce in postcardiotomy cardiogenic shock, right ventricular failure dev
eloped in 5, directly contributing to death in all cases despite initi
ally satisfactory support. Difficulty in grafting a dominant right cor
onary artery was a common factor in all cases. Early consideration sho
uld be given to biventricular support under these circumstances.