What clinical features drive your decision to use prophylactic mechanical circulatory support in a patient with severe left ventricular dysfunction undergoing complex PCI following the CHIP-BCIS3 trial?

I will start by acknowledging that CHIP-BCIS3 did not provide evidence to support routine use of a prophylactic microaxial flow pump (mAFP) device in complex, high-risk interventional procedures for adults with severely reduced left ventricular ejection fraction.

The relatively small size of the tria...

This is a great question for interventional cardiology community. I have been very reserved at using prophylactic mechanical circulatory support in very high risk PCI patients (particularly microaxial flow pump). It has been my observation that mechanical circulatory support is more and more widely ...

Prophylactic mechanical circulatory support should only be used in selective patients rather than routine. The 2021 ACC/AHA/SCAI guidelines recommend mechanical support as a class 2b indication. The CHIP-BCIS3 results weaken this indication even more. Benefit noted in Shock patients with significant...