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Published on: March 26, 2018
Thoracic Incidental Findings in Preoperative Computed Tomography Evaluation for Transcatheter Aortic Valve
Amira F Hussien1, Jean Jeudy, Seth J Kligerman
1*Johns Hopkins Medical Institution †University of Maryland School of Medicine, Baltimore, MD.
Background:
Many older patients with aortic stenosis are excluded from surgical intervention due to multiple comorbidities. For these patients, transcatheter aortic valve implantation (TAVI) is a viable treatment alternative. Cardiothoracic computed tomography (CT) provides detailed anatomic assessment of the aortic root structures for patient selection, preprocedural planning, and intraoperative decision-making; however, nonaortic incidental findings are frequently detected. The prevalence and clinical significance of these findings have not been well described.
Materials And Methods:
This retrospective study examined incidental findings in 209 consecutive patients (96 women and 113 men; mean age, 70 y) with aortic stenosis undergoing preoperative cardiothoracic CT evaluation for TAVI during a 3-year period. Incidental findings were recorded, and medical records were reviewed for follow-up diagnostic examinations.
Results:
Incidental findings, both significant and nonsignificant, were observed in 85.6% of patients (179/209). Noncalcified pulmonary nodules were the most common incidental finding occurring in 59/209 (28.2%) patients, followed by pleural effusion and emphysema both of which occurred in 34/209 (16.3%) patients, respectively.
Conclusions:
Cardiothoracic CT obtained for evaluation before TAVI has a high frequency of incidental findings.
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