FIGURE LEGENDS
Figure 1: Example of preoperative CT-derived anatomic measurements. A. Axial plane midline-to-LV apex distance. B. Coronal plane angulation of LV apex-LV outflow tract axis.
Figure 2: Example of inflow cannula (IFC) angular deviation measurements. Ideal line in each plane is from LV apex through approximate center of mitral valve. Actual position is line through IFC center. A. Anterior plane. Deviation is toward superior (+) or inferior (-) free wall. Illustrated cannula deviates very slightly inferiorly. B. Lateral plane. Deviation is toward septum (-) or lateral wall (+). Illustrated cannula deviates very slightly septally.
Figure 3: CF-LVAD inflow cannula position by surgical technique. Open circles: conventional sternotomy. Black stars: lateral thoracotomy/hemisternotomy
Figure 4: Significant linear relationships between anatomic variables and IFC angles. Best-fit linear regression lines (solid) and 95% confidence intervals (dashed) are shown. A. Anterior plane angle vs LVOT angle (p = 0.01); B. Lateral plane angle as function of LVOT angle (p = 0.04); C. Lateral plane angle as function of apex-midline distance (p = 0.04).
Figure 5: Example patient with higher LVOT angle (35.2 deg) on preoperative CT (A). Postoperative CT demonstrates (B) inferior-wall (-30.6 deg) and (C) lateral-wall directed (+16.9 deg) inflow malposition consistent with regression models.
Figure 6. Box and whisker plots of three-month (A) and six-month (B) VAD flow index (FI) stratified by whether inflow cannula is angulated toward lateral wall. p = 0.002 for both timepoints.
Figure 7. Box and whisker plots of relationship between readmission prevalence and inflow malposition. A. Anterior plane angle and overall heart failure/VAD-related readmissions (HFRAs; p = 0.01). B. Total angular deviation and 30-day HFRAs (p = 0.04).