Ioana Dumitru, MD, describes her institution’s first experience with Impella RP Flex with SmartAssist. The patient was a 40-year-old male with posttransplant right ventricular (RV) failure. With early support from Impella RP Flex, the patient was able to recover with normal cardiac allograft function and end-organ function, avoiding potential retransplantation. Dr. Dimitru is a heart failure transplant cardiologist and the medical director of mechanical circulatory support (MCS) at Tampa General Hospital in Tampa, Florida.