Diagnostic criteria

1. Symptoms and signs of persistent right ventricular dysfunction

2. Central venous Pressure (CVP) > 18 mmHg with Cardiac Index < 2.0 L/min/m²; In the absence of elevated left atrial/pulmonary capillary wedge pressure > 18 mmHg, tamponade, ventricular arrhythmias or pneumothorax

3. Requiring (RVAD) Right Ventricular Assist Device implantation

4. Requiring inhaled nitric oxide

5. Inotropic therapy for duration of more than one week at any time after LVAD implantation

Severity scale

Severe: Requiring RVAD implantation

Moderate: Usage of inotropes or IV or inhaled pulmonary vasodilators such as iNO or prostaglandin E

Mild: Atleast 2 of the 4 criteria:

1. CVP > 18 mmHg or mean RA pressure > 18 mmHg

2. CI < 2.3 L/min/m²

3. Ascites or evidence of moderate to worse peripheral oedema

4. Evidence of elevated CVP by echocardiogram (dilated inferior vena cava without collapse), and in physical exam (signs of increased jugular venous pressure)