Non-Cardiovascular Computed Tomography Incidental Findings in Patients Who Underwent Transaortic Valve Implantation Procedure

Abstract

BackgroundTranscatheter aortic valve implantation (TAVI) is a new treatment option for patients with severe aortic stenosis. Pre-TAVI procedure workup includes computed tomography angiography (CTA) of the heart and aorta from aortic annulus to the iliofemoral arteries. Frequently, there are a number of incidental non-cardiac findings (INCFs) in pre-TAVI CTA. However, the frequency and clinical significance of these INCFs are unknown. The aim of our study was to investigate the prevalence of INCFs and their clinical significance.MethodsThis was a retrospective review of 67 patients who underwent dedicated pre-TAVI CTA from 2010 till 2015. Non-cardiovascular INCFs were classified according to their clinical significance into three categories. The first category includes findings that may require urgent treatment. The second category includes findings that need further follow-up. The third category includes incidental findings that require no further follow-up or recommendation.ResultsThe total number of patients was 67, and the mean age was 73 ± 8 years. All patients had INCFs and the total number was 248. Of the patients, 69% had chest findings, 85% had abdominal findings, and 33% had musculoskeletal findings. Results based on categorical classification were as follows: 9%, 25%, and 66% of these 248 findings belong to the first category, the second category, and the third category, respectively.ConclusionNon-cardiovascular INCFs are common in pre-TAVI CTA presumably due to increased age of such specific population. These findings have variable clinical significance and some of them might require acute treatment or additional evaluation, and should be managed properly taking into consideration patient’s life expectancy and comorbidities.

Outcomes of incidental findings on multi‐detector computed tomography for transcatheter aortic valve implantation assessment: A single‐centre study and review of the literature

“…As the field imaged extends from the mandible to the femoral heads, the scan has one of the highest rates of incidental non‐cardiovascular findings, especially due to the elderly age demographic . The incidence of IF ranges from 20% to 100% due to different definitions of an IF and varying thresholds for reporting by individual radiologists . Renal and lung pathologies were the most commonly reported findings in our study and this is consistent with previous data .…”

Incidental Findings Diagnosed during Preprocedural Evaluation of TAVR

“…But we should underline a considerable number of the patients ( n : 55) had atherosclerotic heart disease diagnosed firstly with pre-TAVR computed tomography. Other papers published before were focused on noncardiac findings on computed tomography [14–16]. So those studies did not mention the relation between senile aortic stenosis and atherosclerotic heart disease.…”