1 Recommendations

Guidance

1.1 Current evidence on the safety of percutaneous insertion of a temporary heart pump for left ventricular haemodynamic support in high-risk percutaneous coronary interventions shows there are serious, infrequent but well-recognised safety concerns. Evidence on efficacy is limited in quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wishing to do percutaneous insertion of a temporary heart pump for left ventricular haemodynamic support in high-risk percutaneous coronary interventions should:

Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information to support shared decision-making. In addition, the use of NICE's information for the public on percutaneous insertion of a temporary heart pump for left ventricular haemodynamic support is recommended.
Details of all patients should be entered into the British Cardiovascular Intervention Society percutaneous coronary interventions database (BCIS PCI database).

1.3 Patient selection should be done by an experienced multidisciplinary team, when the urgency of the clinical situation allows.

1.4 The procedure should only be done in specialised centres by clinicians and teams with specialised training in the use of this technology and experience in complex percutaneous coronary interventions.

1.5 Further research should report details of patient selection and subsequent management.