Thank you! My question stemmed from some theoretical constructs of what constitutes RV failure. I mentioned some of it here:
https://twitter.com/Thind888/status/1228487209617121282

Again, this is mostly theoretical as my clinical experience is limited.

Briefly:
⬆️RV afterload is critical in RV failure.

1/
2/ That is, if we define *RV failure* as heart failure (including cardiogenic shock) where problem is primarily on the right side (RV and/or pulmonary circulation).

Clinically, RV failure is primarily due to ⬆️RV afterload. (E.g. PE, PH). The lack of importance of RV inotropy...
3/ ... (in normal conditions) other than the fact that RV ejection is significantly assisted by the septum... is highlighted by the classic studies where RV free wall was cauterized in dogs with minimal hemodynamic consequences.

Plus Fontan works as long as their PVR is fine.
You can follow @Thind888.
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