Background: Frailty influences the postoperative outcomes in patients
undergoing left ventricular assist device (LVAD) implantation; however,
a quantitative evaluation method has not been established. The purpose
of the present study was to evaluate whether preoperative ESM mass is
associated with short- and long-term clinical outcomes in patients with
LVAD. Methods: A total of 119 consecutive patients with LVAD were
enrolled between January 2010 and October 2017 at a single heart center.
The ESM index and Hounsfield units (HU) of the ESM were calculated by
computed tomography for preoperative ESM mass evaluation. We then
statistically evaluated the in-hospital mortality, major adverse
cardiovascular events (MACE), duration of hospital stay, and long-term
survival. Results: In a multivariate Cox regression analysis, ESM index
and HU of the ESM indicated no effect on the in-hospital mortality,
MACE, and long-term survival. In addition, the ESM index presented a
weak but significant negative linear correlation only with the duration
of hospital stay (r = -0.21, p < 0.05). In contrast, the model
for end-stage liver disease (MELD) score and preoperative
venous-arterial extracorporeal membrane oxygenation (va-ECMO) were
significant predictive factors for in-hospital mortality (MELD score: p
< 0.001, hazard ratio [HR] 1.1; preoperative va-ECMO: p
< 0.01, HR 2.72) and MACE (MELD score: p < 0.001, HR
1.07; preoperative va-ECMO: p < 0.005, HR 2.62). Conclusion:
Preoperative ESM mass might predict the length of hospital stay in
patients undergoing LVAD implantation. In contrast, it had no effect on
MACE, in-hospital mortality, or long-term survival in this study.
Long-term support of patients receiving a left ventricular assist device for advanced heart failure: a follow-up analysis of the Registry to Evaluate the HeartWare Left Ventricular Assist System
