Cardiac cachexia with associated sarcopenia and frailty has been associated with adverse outcomes after placement of a durable left ventricular assist device (LVAD). The purpose of this study is to examine whether the pectoralis muscle index (PMI) measured from preoperative CT scans of the chest will predict outcomes after LVAD implantation. We retrospectively reviewed preop CT scans of the chest on 76 LVAD patients implanted between 1/2017 and 8/2018. The axial CT slice with the greatest pectoralis area at or near the level of the sternoclavicular joint was identified, and PMI was calculated by dividing the measured pectoralis area in cm by the patient's height in m2. Kruskal-Wallis test was used to compare length of stay, Fisher's Exact test to assess mortality and readmission rates. The overall survival was by Kaplan-Meier estimate, and the Log-Rank test was used to compare the survival curves. A total of 76 LVAD patients were included. Subjects were divided into low, medium, and high PMI terciles (Table 1). 30/60/90 day mortality, length of stay, and 30-day readmission rate trended higher in patients with the lowest PMI, although the differences did not reach statistical significance. Overall mortality (Figure 1) also clearly trended by PMI tercile but did not reach statistical significance in this population. Preoperative PMI may be a predictor of outcomes post LVAD implant independently, and value in our center might be better defined with a larger sample size. The value of PMI could potentially be enhanced by combination with other assessments of sarcopenia, such as psoas muscle area.