Background The development of right ventricular failure (RVF) is common following continuous-flow left ventricular assist device (CF-LVAD) implantation, occurring in 13%-40% of patients. With the LVAD and right heart operating in series, LVAD function relies heavily on RV function for adequate preload. Severe RVF can lead to systemic hypoperfusion, multi-organ failure, prolonged hospitalization, poor quality of life, and death. Hypothesis Identifying patients at risk of developing severe RVF post-implantation may assist the care team in taking the necessary precautions to potentially avoid RVF or to be aggressive in its management. Methods This was a single-center review of CF-LVAD implantations from 2014 to 2016. Excluded were INTERMACS1 patients, redo LVADs, preoperative advanced RVF, refractory pulmonary vascular resistance >6 WU, and prosthetic mitral or tricuspid valve. RVF was defined as requiring RVAD or inhaled nitric oxide or other pulmonary vasodilator post-op for ≥48h or inotropic therapy for ≥7d any time post-op. Assessment of pre-implant RV function was based on an extensive set of echocardiographic parameters ( Tables 1 & 2 ). Results Of 55 patients (95% were HeartMate II), a total of 46 (84%) developed significant RVF. Those with and without RVF did not differ in gender or age. RV stroke volume (P=0.04), RV stroke volume index (P=0.04), and mitral valve regurgitation jet area (P=0.05) were significantly lower in patients with RVF ( Table 1 ). Conclusion RV cardiac output is calculated as RV stroke volume x heart rate. Thus, early RVF post-LVAD may be explained by low RV stroke volume. In standard practice, however, RV stroke volume and RV stroke volume index are not routinely calculated from the pre-implant echocardiogram. This study, despite its small sample size, suggests potential prognostic value for these echo parameters for the evaluation of RVF. Larger studies are needed to validate these results.