{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:04:25Z","timestamp":1785398665347,"version":"3.56.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Temporary mechanical circulatory support (tMCS) for refractory post-cardiac surgery cardiogenic shock (PCCS) is required in 1-2% of cardiac surgical patients. As a prelude to a year-long national service evaluation of tMCS provision in this context, we undertook the first national system-level evaluation of the infrastructure and governance of tMCS for adult cardiac surgery in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey was distributed to the Association for Cardiothoracic Anaesthesia &amp; Critical Care Linkperson Network, including all 35 UK adult cardiac surgical centres. The twenty-question survey inquired about local tMCS availability and use, management of PCCS, reporting frameworks and other local resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Complete results were obtained from 26 centres (74%), including two-thirds of the UK\u2019s adult heart transplant centres. Centres reported preoperative tMCS use in 1.4%, and up to 4% postoperatively. All centres could provide intra-aortic balloon pump support, which was the most common therapy nationally. Transvalvular microaxial flow pump (39% of centres), venoarterial extracorporeal membrane oxygenation (54%) and ventricular assist devices (19%) were less widely available and less frequently used. Most centres (89%) reported no protocol for the management of PCCS and no local shock team (85%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The UK currently lacks a co-ordinated perioperative tMCS pathway, and there is marked heterogeneity in the organisation, availability and delivery of perioperative tMCS services across the UK. There is a need to address key system-level gaps, with nationally coordinated pathways, multidisciplinary shock models, standardised reporting structures and network-based referral systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261473450","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:12:33Z","timestamp":1785226353000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A national evaluation of perioperative temporary mechanical circulatory support infrastructure and governance in the UK: A survey of adult cardiac surgical centres"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-6125","authenticated-orcid":false,"given":"Benjamin","family":"Milne","sequence":"first","affiliation":[{"name":"Guy\u2019s & St Thomas\u2019 Hospital NHS Foundation Trust"},{"name":"Guy\u2019s & St Thomas\u2019 Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Charlton","sequence":"additional","affiliation":[{"name":"Glenfield Hospital"},{"name":"University Hospitals of Leicester NHS Trust"},{"name":"University of Leicester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakeem","family":"Yusuff","sequence":"additional","affiliation":[{"name":"Glenfield Hospital"},{"name":"University Hospitals of Leicester NHS Trust"},{"name":"University of Leicester"},{"name":"National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Zochios","sequence":"additional","affiliation":[{"name":"Glenfield Hospital"},{"name":"University Hospitals of Leicester NHS Trust"},{"name":"University of Leicester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9789-1334","authenticated-orcid":false,"given":"Gudrun","family":"Kunst","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust"},{"name":"King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13072118"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2025.01.007"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)01329-8"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-016-0430-2"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004922"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.029609"},{"issue":"11","key":"e_1_3_5_8_2","first-page":"102671","article-title":"Impact of preoperative temporary mechanical circulatory support on durable LVAD outcomes: an analysis of the Society of Thoracic Surgeons National Intermacs Database","volume":"13","author":"Kanwar MK","year":"2025","unstructured":"Kanwar MK, Shah P, Cascino T, et al. Impact of preoperative temporary mechanical circulatory support on durable LVAD outcomes: an analysis of the Society of Thoracic Surgeons National Intermacs Database. JACC (J Am Coll Cardiol): Heart Fail. 2025; 13(11): 102671. https:\/\/doi.org\/10.1016\/j.jchf.2025.102671","journal-title":"JACC (J Am Coll Cardiol): Heart Fail"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-024-02961-y"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.07.035"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2025.133895"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.09.023"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06737-1"},{"key":"e_1_3_5_14_2","volume-title":"National adult cardiac surgery audit (NACSA)2025 annual report","author":"National Institute for Cardiovascular Outcomes Research (NICOR)","year":"2025","unstructured":"National Institute for Cardiovascular Outcomes Research (NICOR). National adult cardiac surgery audit (NACSA)2025 annual report. Derby, 2025."},{"key":"e_1_3_5_15_2","volume-title":"Scottish cardiac audit programme report 2024\/2025","author":"Public Health Scotland","year":"2025","unstructured":"Public Health Scotland. Scottish cardiac audit programme report 2024\/2025. Edinburgh, 2025."},{"key":"e_1_3_5_16_2","article-title":"VA ECMO for severe acute heart failure in adults","author":"National Institute of Health and Care Excellence","unstructured":"National Institute of Health and Care Excellence. VA ECMO for severe acute heart failure in adults. HealthTech Guidance (HTG764). Published 22nd October 2025. https:\/\/www.nice.org.uk\/guidance\/htg764. Accessed 20th March 2026.","journal-title":"HealthTech Guidance (HTG764)"},{"key":"e_1_3_5_17_2","article-title":"VA ECMO for postcardiotomy cardiogenic shock in adults","author":"National Institute of Health and Care Excellence","unstructured":"National Institute of Health and Care Excellence. VA ECMO for postcardiotomy cardiogenic shock in adults. HealthTech Guidance (HTG762). Published 18th December 2025. https:\/\/www.nice.org.uk\/guidance\/htg762. Accessed 20th March 2026.","journal-title":"HealthTech Guidance (HTG762)"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2025.01.015"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaf296"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.07.044"},{"issue":"1","key":"e_1_3_5_21_2","doi-asserted-by":"crossref","first-page":"e003794","DOI":"10.1136\/openhrt-2025-003794","article-title":"Advanced cardiogenic-shock team versus standard care in cardiogenic shock: a single centre service evaluation project","volume":"13","author":"Mohan NC","year":"2026","unstructured":"Mohan NC, Govier M, Johnson TW, et al. Advanced cardiogenic-shock team versus standard care in cardiogenic shock: a single centre service evaluation project. Open Heart 2026; 13(1): e003794. https:\/\/doi.org\/10.1136\/openhrt-2025-003794","journal-title":"Open Heart"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.06.077"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14887"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.12.026"},{"key":"e_1_3_5_25_2","volume-title":"Guidelines for the provision of intensive care services (GPICS)","author":"Faculty of Intensive Care Medicine and Intensive Care Society","year":"2026","unstructured":"Faculty of Intensive Care Medicine and Intensive Care Society. Guidelines for the provision of intensive care services (GPICS). 3rd ed. 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The Royal College of Anaesthetists, 2025."},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.1153"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13291"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S259908"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261473450","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261473450","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261473450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:47:03Z","timestamp":1785397623000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261473450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":28,"alternative-id":["10.1177\/02676591261473450"],"URL":"https:\/\/doi.org\/10.1177\/02676591261473450","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"02676591261473450"}}