Catheter-based embolectomy prior to right ventricular mechanical circulatory support placement after heart transplantation.

Severe acute isolated right ventricular failure has limited dedicated percutaneous temporary mechanical circulatory support options, especially after orthotopic heart transplantation. The advent of the Impella RP device provides a newer option, though an absolute contraindication to device placement is thrombus within the right heart. We present a novel case where catheter-based embolectomy was used to evacuate right heart thrombus before Impella RP placement in a patient with severe acute right ventricular failure due to primary graft dysfunction after orthotopic heart transplantation.