Applications

1523.1 – Transluminal insertion, management and removal of an intravascular microaxial blood pump (Impella®), for patients requiring mechanical circulatory support

Find out about the service or technology in this application and the medical condition it addresses. You can also view the application documents, the deadlines for providing consultation input and the outcome of the application when the MSAC process is complete.

  • Status Complete
  • Type Re-application
  • Pre-PASC consultation Not applicable
  • Pre-MSAC consultation Closed
  • Outcome Supported

Application details

Reason for application

New MBS item

Service or technology in this application

Impella is a transluminal microaxial ventricular assist device that is inserted percutaneously or surgically.

The Impella devices have a small microaxial pump (at one end of a thin, flexible catheter) that pumps blood from the left ventricle through an inlet area near the tip and expels blood into the ascending aorta. The other end of the tube is connected to an automated control system outside the body (that controls the pump rate). The Impella technology is part of the latest generation of cardiac assist devices. The device stabilises haemodynamics, unloads the ventricle, augments peak coronary flow, perfuses the end organs, reduces myocardial oxygen demand and allows for recovery of the native heart. It is indicated for clinical use in interventional cardiology and cardiac surgery for supporting the native heart in patients with reduced ventricular function.

Type: Therapeutic technology

Medical condition this application addresses

Cardiogenic shock is a complex clinical syndrome, a medical life-threatening emergency, with poor prognosis, which occurs when the heart suddenly cannot pump enough blood and oxygen to the brain and other vital organs. It is defined as a state of end-organ hypoperfusion caused by left ventricular, right ventricular, or biventricular myocardial injury resulting in systolic and/or diastolic myocardial pump failure (Kar 2011). It is characterised by a self-propagating cascade of acute, falling cardiac output and hypotension with ensuing compromised end-organ perfusion. Without appropriate intervention, the end result is multi-organ failure and death (National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand 2018 guidelines for the prevention, detection, and management of heart failure in Australia (NHFA CSANZ 2018).

Previous applications

1523 – Transluminal insertion, management, repositioning and removal of an intravascular microaxial blood pump (Impella?), for patients requiring mechanical circulatory support

Application documents

Application summary

Consultation survey

PICO set

Public summary document

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Consultation survey and deadlines

  • PASC consultation: Not applicable
  • MSAC consultation: Closed Friday, 16 February 2024

Meetings to consider this application

  • PASC meeting: Expedited - bypassed PASC
  • ESC meeting: 15 to 16 February 2024
  • MSAC meeting: 4 to 5 April 2024