ABC Heart Fail Cardiomyop 2025; 5(2): e20250017
Advanced Management of Right Heart Failure: An Illustrative Case
Pedro Castilhos de Freitas Crivelaro
, Guilherme Pinheiro Machado
, Marcelo Basso Gazzana
, William Lorenzi
, Igor Gorski Benedetto
, Felipe Homem Valle
, Rodrigo Vugman Wainstein
Abstract
Right heart failure (RHF) is a serious condition characterized by the inability of the right ventricle (RV) to generate sufficient output for pulmonary circulation, leading to systemic congestion and hypoperfusion. Proper management of RHF is essential to improve prognosis and quality of life, requiring individualized treatment based on hemodynamic assessment.
This article reviews pathophysiology, diagnosis, and therapeutic options for RHF, including strategies for preload optimization, afterload reduction, and advanced circulatory support. Additionally, it presents a clinical case of a patient with severe RHF secondary to chronic pulmonary thromboembolism and primary tricuspid regurgitation, treated with a hybrid approach involving balloon pulmonary angioplasty and pulmonary thromboendarterectomy combined with surgical valve repair, resulting in significant functional improvement. This review highlights the importance of personalized strategies and combined therapies in the management of advanced RHF.
Keywords: Heart Failure; Heart Ventricles; Pulmonary Hypertension
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