Study design and data collection
This retrospective study analyzed 168 consecutive patients with LVAD between January 2010 and October 2017 at a single heart center. Patients who did not undergo preoperative chest CT evaluations were excluded from this study. In total, 119 patients were enrolled in the study. The purpose of this study was to examine the ability of preoperative ESM mass as a predictive factor for postoperative clinical outcomes in patients undergoing LVAD implantation. To realize this purpose, we provided two endpoints in this study. The primary endpoint was the clinical outcome at hospital discharge, and the secondary endpoint was the postoperative follow-up status up to December 2019 (766 ± 889 days, median 372 days), in which patients who had already undergone heart transplantation (HTX) were also considered to be “living after LVAD implantation,” similar to other LVAD patients. Within the category of the primary endpoint, we analyzed the in-hospital mortality, major adverse cardiovascular events (MACE), and the duration of hospital stay. On the other hand, at the secondary endpoint, only the survival rate in the follow-up periods was analyzed. The collected patient data were pseudonymized and arranged in numerical order. As a preoperative liver function assessment, the model for end-stage liver disease (MELD) score was evaluated based on the following formula; 3.78 × (bilirubin) + 11.2 × (international normalized ratio) + 9.57 × (creatinine) + 6.43. In this study, MACE was defined as a postoperative cerebral vascular event, a cardiac event including operative or interventional procedures, or cardiac death.