Dear Sirs,
We would like to thank Professor Stephen Westaby for his interesting editorial1 on mechanical circulatory support in the setting of the National Institute for Health and Care Excellence (NICE) guidelines on acute heart failure. He discusses two examples of patients who were not served well by the current commissioning arrangements in place for acute heart failure and longer term ventricular assist device (VAD) destination therapy, and argues compassionately for a widening of access to technologies such as extracorporeal membrane oxygenation (ECMO) and left VAD (LVAD) to support patients where required.
We could not agree more. With