ArticleThe international journal of cardiovascular imaging2015
Clinical and economic consequences of non-cardiac incidental findings detected on cardiovascular computed tomography performed prior to transcatheter aortic valve implantation (TAVI).
Article in The international journal of cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Incidental findings on routine preoperative noncontrast chest computed tomography and chest radiography prior to cardiac surgery in the multicenter randomized controlled CRICKET study.European radiology · 2023Trial
- Observational
- Incidental findings on computed tomography for preoperative assessment before transcatheter aortic valve implantation in Japanese patients.Heart and vessels · 2021Observational
- Coronavirus disease 2019 (COVID-19) pneumonia incidentally detected on coronary CT angiogram: a do-not-miss diagnosis.Emergency radiology · 2020Article
- Frequency and impact of incidental findings on computed tomography during work-up for transcatheter aortic valve implantation: single centre experience and review of the literature.The British journal of radiology · 2019Review
- Incidental Non-cardiac Findings in Cardiovascular Imaging.Current treatment options in cardiovascular medicine · 2018Review
- Extracardiac findings on computed tomography attenuation correction: Is it worth paying extra attention?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Prognostic impact of myocardial perfusion single photon emission computed tomography in patients with major extracardiac findings by computed tomography for attenuation correction.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Incidental findings in multislice computed tomography prior to transcatheter aortic valve implantation: frequency, clinical relevance and outcome.The international journal of cardiovascular imaging · 2018Observational
- Cost-utility of surgical sutureless bioprostheses vs TAVI in aortic valve replacement for patients at intermediate and high surgical risk.ClinicoEconomics and outcomes research : CEOR · 2018Article
- Renal incidental findings on computed tomography: Frequency and distribution in a large non selected cohort.Medicine · 2017Observational
- Patient selection for transcatheter aortic valve replacement: A combined clinical and multimodality imaging approach.World journal of cardiology · 2017Review
- Non-Cardiovascular Computed Tomography Incidental Findings in Patients Who Underwent Transaortic Valve Implantation Procedure.Cardiology research · 2017Article
- Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Transcatheter aortic valve implantation (TAVI) is an effective treatment option for patients with severe degenerative aortic valve stenosis who are high risk for conventional surgery. Computed tomography (CT) performed prior to TAVI can detect pathologies that could influence outcomes following the procedure, however the incidence, cost, and clinical impact of incidental findings has not previously been investigated. 279 patients underwent CT; 188 subsequently had TAVI and 91 were declined. Incidental findings were classified as clinically significant (requiring treatment), indeterminate (requiring further assessment), or clinically insignificant. The primary outcome measure was all-cause mortality up to 3 years. Costs incurred by additional investigations resultant to incidental findings were estimated using the UK Department of Health Payment Tariff. Incidental findings were common in both the TAVI and medical therapy cohorts (54.8 vs. 70.3%; P = 0.014). Subsequently, 45 extra investigations were recommended for the TAVI cohort, at an overall average cost of £32.69 per TAVI patient. In a univariate model, survival was significantly associated with the presence of a clinically significant or indeterminate finding (HR 1.61; P = 0.021). However, on multivariate analysis outcomes after TAVI were not influenced by any category of incidental finding. Incidental findings are common on CT scans performed prior to TAVI. However, the total cost involved in investigating these findings is low, and incidental findings do not independently identify patients with poorer outcomes after TAVI. The discovery of an incidental finding on CT should not necessarily influence or delay the decision to perform TAVI.
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