Abstract
Management of pulmonary arterial hypertension (PAH) with concomitant decompensated right-sided heart failure refractory to conventional pharmacotherapy presents a significant and multifaceted medical challenge. Although extracorporeal membrane oxygenation has been proven as an effective emergency intervention for unresponsive cardiopulmonary failure, the alternative use of a right ventricular assist device (RVAD) holds promise in the appropriate setting. We present a case of RVAD use in a patient with life-threatening acute PAH who was successfully bridged through critical decompensation to discharge without the need for more invasive procedures.