ArticleCardiovascular intervention and therapeutics2026
Practice variation in mechanical circulatory support: a cross-sectional questionnaire survey of Japanese interventional cardiologists in the CVIT Kyushu-Okinawa chapter.
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Abstract
Mechanical circulatory support (MCS) practice for cardiogenic shock may vary with institutional resources and operator experience, but data from Japanese interventional cardiologists are limited. We conducted an anonymous cross-sectional survey of 720 members of 83 Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT)-certified or affiliated training hospitals in the CVIT Kyushu-Okinawa Chapter (September-October 2025); 536 returned questionnaires (74.4%), and consent was confirmed for 385 (53.5%). The primary analysis included 276 respondents who had performed intra-aortic balloon pump (IABP), veno-arterial extracorporeal membrane oxygenation (VA-ECMO), or Impella CP insertion within 12 months: 163 at Impella-capable and 113 at non-Impella-capable hospitals. Documented MCS and extracorporeal cardiopulmonary resuscitation protocols were more frequently reported by respondents from Impella-capable hospitals (46% vs. 6% and 39% vs. 13%, respectively), as was collaboration with emergency and critical care physicians; no statistically significant difference was detected in perceived need for collaboration. MCS selection varied between groups. At Society for Cardiovascular Angiography and Interventions (SCAI) shock stage C, IABP (44%) and Impella CP (48%) were selected with similar frequency among respondents in Impella-capable hospitals, whereas IABP was selected by 79% in non-Impella-capable hospitals. At stage E, ECPELLA (79%) and VA-ECMO plus IABP (84%) predominated, respectively. Among respondents with device-specific operator experience within 12 months, vascular access and anticoagulation practices varied between groups. Procedural anxiety was lower with higher CVIT qualification; however, 19% of board-certified members reported anxiety about Impella CP insertion and 45% about emergency intubation. These findings identify MCS practice variation across several domains warranting further evaluation.
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