Markowiak, Till and Holzamer, Andreas and Hilker, Michael and Pregler, Benedikt and Debl, Kurt and Hofmann, Hans-Stefan and Ried, Michael (2019) Incidental thoracic findings in computed tomography scans before transcatheter aortic valve implantation. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 28 (4). pp. 559-565. ISSN 1569-9293, 1569-9285
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OBJECTIVES: Preoperative computed tomography (CT) scans for transcatheter aortic valve implantation (TAVI) are used routinely. In elderly high-risk patients, incidental radiographic findings are frequently reported. The aim of this study was to investigate the impact of auxiliary findings on the patients' mid-term survival, which might affect the treatment strategy. METHODS: Between March 2011 and April 2016, all radiological reports of contrast-enhanced CT scans of 976 patients scheduled for TAVI were analysed retrospectively for incidental thoracic findings including solitary pulmonary nodules (SPN) and thoracic lymphadenopathy (LAP). The minimum follow-up period was 1 year after TAVI. RESULTS: The median age of all patients was 79 years; 51.9% (n=507) were women. Approximately 37% (n=361) of patients showed 1 of the determined findings. An SPN >= 5 mm was diagnosed in 16.4% (n=160) of patients. Four of them developed lung cancer and 2 nodules were identified as metastases during follow-up. In addition, 12% (n=117) of the patients had thoracic LAP. Whereas SPN had no significant effect on the overall survival rate, evidence of LAP turned out to be a statistically significant factor regarding 4-year survival (P=0.001; hazard ratio 1.66; 95% confidence internal 1.19-2.31). CONCLUSIONS: SPN >= 5 mm were detected in 16.4% of patients scheduled for TAVI. Nevertheless, the incidence of lung cancer was low and the effect on survival in this high-risk group of patients was statistically not significant. In contrast, thoracic LAP had a significant negative effect on survival. It needs to be proven if the outcome of this cohort can be enhanced by further diagnostics and therapy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LUNG-CANCER; RISK; REPLACEMENT; OUTCOMES; STENOSIS; SURVIVAL; SOCIETY; Transcatheter aortic valve implantation; Lung cancer; Solitary pulmonary nodule; Thoracic lymphadenopathy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Abteilung für Thoraxchirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Apr 2020 07:16 |
| Last Modified: | 14 Apr 2020 07:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27190 |
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