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.