UNLABELLED: Background: Trans-cathetervalve implantation (TAVI) is a non- surgical alternative for patients with severe aortic stenosis (AS). Pre-procedural computed tomography angiography (CTA) allows accurate "road mapping," aortic annulus sizing and the detection of incidental findings. OBJECTIVES: To document the prevalence of non-valvular extracardiac findings on CTA prior to TAVI and the impact of these findings on the procedure. METHODS: Ninety AS patients underwent CTA as part of pre-TAVI planning. Scans extended from the clavicles to the groin. Non-vascular non-valvular findings were documented and graded as follows: (A) significant findings causing TAVI cancellation or postponement, (B) significant findings leading to a change in the TAVI procedure approach, (C) non-significant findings not affecting the TAVI procedure. RESULTS: TAVI was planned for 90 patients; their average age was 80.2 ± 7.5 years, 53% were females. Overall, non-valvular cardiac, extracardiac and extravascular significant and non-significant incidental findings were documented in 97% of scans (87/90). Significant pathologies causing TAVI cancellation or postponement (category A) were documented in 8%. Significant findings affecting the TAVI procedure (category B) were found in 16% of patients. CONCLUSIONS: Pre-TAVI CTA detected non-valvular extravascular pathologies leading to procedure cancellation/postponement or procedure modification in 8% and 16%, respectively. Comprehensive CTA evaluation that acknowledges the importance of such findings is of major importance since it might alter the TAVI procedure or even render it inappropriate.
UNLABELLED: Background: Trans-cathetervalve implantation (TAVI) is a non- surgical alternative for patients with severe aortic stenosis (AS). Pre-procedural computed tomography angiography (CTA) allows accurate "road mapping," aortic annulus sizing and the detection of incidental findings. OBJECTIVES: To document the prevalence of non-valvular extracardiac findings on CTA prior to TAVI and the impact of these findings on the procedure. METHODS: Ninety AS patients underwent CTA as part of pre-TAVI planning. Scans extended from the clavicles to the groin. Non-vascular non-valvular findings were documented and graded as follows: (A) significant findings causing TAVI cancellation or postponement, (B) significant findings leading to a change in the TAVI procedure approach, (C) non-significant findings not affecting the TAVI procedure. RESULTS: TAVI was planned for 90 patients; their average age was 80.2 ± 7.5 years, 53% were females. Overall, non-valvular cardiac, extracardiac and extravascular significant and non-significant incidental findings were documented in 97% of scans (87/90). Significant pathologies causing TAVI cancellation or postponement (category A) were documented in 8%. Significant findings affecting the TAVI procedure (category B) were found in 16% of patients. CONCLUSIONS: Pre-TAVI CTA detected non-valvular extravascular pathologies leading to procedure cancellation/postponement or procedure modification in 8% and 16%, respectively. Comprehensive CTA evaluation that acknowledges the importance of such findings is of major importance since it might alter the TAVI procedure or even render it inappropriate.
Authors: 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 Journal: Int J Cardiovasc Imaging Date: 2018-02-21 Impact factor: 2.357
Authors: Jonathan Hinton; Sam Gough; Hanad Ahmed; Lavinia Gabara; John Rawlins; Alison Calver; Benoy N Shah; Dhrubo Rakhit; James Shambrook; Stephen Harden; Charles Peebles; Ausami Abbas; Nick Curzen Journal: Br J Radiol Date: 2019-08-12 Impact factor: 3.039
Authors: Emmanouil Chourdakis; Ioanna Koniari; Nicholas G Kounis; Dimitrios Velissaris; Nikolaos Koutsogiannis; Grigorios Tsigkas; Karl Eugen Hauptmann; Bruno Sontag; George Hahalis Journal: J Geriatr Cardiol Date: 2018-01 Impact factor: 3.327