Incidental findings in multislice computed tomography prior to transcatheter aortic valve implantation: frequency, clinical relevance and outcome

Teresa Trenkwalder, Anna Lena Lahmann, Magdalena Nowicka, Costanza Pellegrini, Tobias Rheude, N. Patrick Mayr, Stephanie Voss, Sabine Bleiziffer, Rüdiger Lange, Michael Joner, Albert M. Kasel, Adnan Kastrati, Heribert Schunkert, Oliver Husser, Martin Hadamitzky, Christian Hengstenberg

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exact incidence, clinical relevance and further consequences of IF are unclear and it is controversial whether IF adversely affect patients’ outcome. We analyzed MSCT data of 1050 patients screened for TAVI between January 2011 and December 2014. Median follow-up of patients was 20 months. In total, 3194 IF were identified, which were classified into clinically non-relevant IF (2872, 90%) and clinically relevant IF (322, 10%). In 25% of patients (258/1050) at least one clinically relevant IF was present. Age (80 ± 7 vs. 80 ± 7 years; p = 0.198) and EuroSCORE II (3.6% [2.1–5.7] vs. 3.6% [2.1–5.9]; p = 0.874) was similar between patients with and without a clinically relevant IF. TAVI was performed less frequently in patients with a clinically relevant IF (76% vs. 85%; p < 0.001), with more patients receiving surgical aortic valve replacement in that group (14% vs. 11%; p = 0.042), possibly due to the high rate of incidental aneurysms of the ascending aorta (n = 48). If TAVI was performed mortality did not differ (30-days: 4% vs. 3%; p = 0.339, 1-year: 11% vs. 14%; p = 0.226) between patients with and without a clinically relevant IF. Our study is the largest study to analyze prevalence, clinical relevance and therapeutic consequences of IF during screening for TAVI. IF in pre-procedural MSCT are common and clinically relevant in one-quarter of patients. However, these findings had no impact on overall mortality.

Original languageEnglish
Pages (from-to)985-992
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume34
Issue number6
DOIs
StatePublished - 1 Jun 2018

Keywords

  • Aortic valve stenosis
  • Incidental findings
  • Multislice computed tomography
  • TAVI

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