Extracardiac pathological findings in computed tomography prior to transcatheter aortic valve replacement
DOI:
https://doi.org/10.29076/issn.2602-8360vol10iss18.2026pp130-138pKeywords:
TAVI, multidetector computed tomography, radiological findingsAbstract
Currently, transcatheter aortic valve replacement (TAVI) has become the treatment of choice for most patients with severe aortic stenosis. Prior to carrying out this procedure, it is necessary to perform a multidetector computed tomography (TCMD) to obtain a reliable measurement of the aortic valve annulus, and in which it is frequent to detect incidentally pathological findings at the extracardiac level with important clinical repercussions, and may even lead to the contraindication of the procedure. The aim of this study was to describe the frequency and impact of this type of finding in a series of patients who were candidates for TAVI. Through a retrospective study that included all patients with severe aortic stenosis evaluated by MDCT prior to performing TAVI at the Hospital Clínico San Carlos (Madrid) during the period between January 2020 and March 2023. The incidence of pathological findings was studied. extracardiac events classified by system, as well as their impact on the performance or not of the TAVI procedure. Findings were classified as significant (high clinical relevance and requiring immediate management), indeterminate (medium clinical relevance and not requiring immediate management), or not significant (no clinical relevance). A total of 538 patients were included. The mean age of the patients was 82 years and 53.9% were women. A total of 2166 extracardiac findings were found. Of the total findings, 8.68% were significant, 49.84% indeterminate, and 41.74% not significant. The systems that most predominated in pathological results were the digestive (28.35%) and respiratory (26.41%) systems, followed by the lymphohematopoietic and endocrine (16.99%), urogenital (16.07%), and musculoskeletal (12.19%). In 14 patients (2.60%), the procedure was canceled due to the pathologies found. Extracardiac pathological findings are very common in MDCT performed on patients who are candidates for TAVI due to their advanced age and multiple comorbidities.
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