Heart failure patients are increasingly requiring left ventricular assist device placement; however, definitive evaluation of both left and right ventricular function is required due to the increased mortality rate associated with right heart failure after assist device placement. Our results, looking at 9 patients with advanced heart failure, suggest that first pass radionuclide angiography only has a moderate correlation with right ventricular ejection fraction calculated using cardiac MR. Given the need for improved identification of patients at risk for right heart failure, our study suggests that further studies are warranted to find a more accurate estimate of right ventricular ejection fraction for heart failure patients, and with the expected increase in availability of MR-conditional devices, that cardiac MR should be further investigated as a definitive assessment for ventricular function prior to left ventricular assist device placement.