ArticleEuropean radiology2022
DEtection of ProxImal Coronary stenosis in the work-up for Transcatheter aortic valve implantation using CTA (from the DEPICT CTA collaboration).
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Coronary CTA and CT-FFR in trans-catheter aortic valve implantation candidates: a systematic review and meta-analysis.European radiology · 2025Pooled it
- Invasive Evaluation of Coronary Artery Disease in Severe Aortic Stenosis-A Narrative Review.Journal of clinical medicine · 2026Review
- Single-visit cardiac functional assessment by cine CT added to CCTA: segment-level validation of low-dose recirculation timing protocol.European radiology · 2026Article
- Combined Computed Coronary Tomography Angiography and Transcatheter Aortic Valve Implantation (TAVI) Planning Computed Tomography Reliably Detects Relevant Coronary Artery Disease Pre-TAVI.Journal of clinical medicine · 2024Article
- Computed tomography imaging in preprocedural planning of transcatheter valvular heart interventions.The international journal of cardiovascular imaging · 2024Review
- Diagnostic performance of deep learning to exclude coronary stenosis on CT angiography in TAVI patients.The international journal of cardiovascular imaging · 2024Article
- Time to Go with the Flow in Coronary Artery Disease in TAVR?Radiology. Cardiothoracic imaging · 2024Article
- Utility of Coronary Computed Tomography Angiography in Patients Undergoing Transcatheter Aortic Valve Implantation: A Meta-Analysis and Meta-Regression Based on Published Data from 7458 Patients.Journal of clinical medicine · 2024Article
- Combined CT Coronary Artery Assessment and TAVI Planning.Diagnostics (Basel, Switzerland) · 2023Review
- Coronary Artery Disease and Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement.Reviews in cardiovascular medicine · 2022Review
- Correlation of Computed Tomographic Angiography in Patients Undergoing Coronary Artery Bypass Grafting and Effect of Standardized Rehabilitation Nursing.Computational intelligence and neuroscience · 2022Article
- Challenges in Diagnosis and Functional Assessment of Coronary Artery Disease in Patients With Severe Aortic Stenosis.Frontiers in cardiovascular medicine · 2022Review
- Coronary Artery Disease in Patients with Aortic Stenosis and Transcatheter Aortic Valve Implantation: Implications for Management.European cardiology · 2021Review
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16 authors at 8 institutions in 6 countries.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesComputed tomography angiography (CTA) is performed routinely in the work-up for transcatheter aortic valve implantation (TAVI), and could potentially replace invasive coronary angiography (ICA) to rule out left main (LM) and proximal coronary stenosis. The objectives were to assess the diagnostic yield and accuracy of pre-TAVI CTA to detect LM and proximal coronary stenosis of ≥ 50% and ≥ 70% diameter stenosis (DS).
methodsThe DEPICT CTA database consists of individual patient data from four studies with a retrospective design that analyzed the diagnostic accuracy of pre-TAVI CTA to detect coronary stenosis, as compared with ICA. Pooled data were used to assess diagnostic accuracy to detect coronary stenosis in the left main and the three proximal coronary segments on a per-patient and a per-segment level. We included 1060 patients (mean age: 81.5 years, 42.7% male).
resultsOn ICA, the prevalence of proximal stenosis was 29.0% (≥ 50% DS) and 15.7% (≥ 70% DS). Pre-TAVI CTA ruled out ≥ 50% DS in 51.6% of patients with a sensitivity of 96.4%, specificity of 71.2%, PPV of 57.7%, and NPV of 98.0%. For ≥ 70% DS, pre-TAVI CTA ruled out stenosis in 70.0% of patients with a sensitivity of 96.7%, specificity of 87.5%, PPV of 66.9%, and NPV of 99.0%.
conclusionCTA provides high diagnostic accuracy to rule out LM and proximal coronary stenosis in patients undergoing work-up for TAVI. Clinical application of CTA as a gatekeeper for ICA would reduce the need for ICA in 52% or 70% of patients, using a threshold of ≥ 50% or ≥ 70% DS, respectively. KEY POINTS: • Clinical application of CTA as a gatekeeper for ICA would reduce the need for ICA in 52% or 70% of TAVI patients, using a threshold of ≥ 50% or ≥ 70% diameter stenosis. • The diagnostic accuracy of CTA to exclude proximal coronary stenosis in these patients is high, with a sensitivity of 96.4% and NPV of 98.0% for a threshold of ≥ 50%, and a sensitivity of 96.7% and NPV of 99.0% for a threshold of ≥ 70% diameter stenosis. • Atrial fibrillation and heart rate did not significantly affect sensitivity and NPV. However, a heart rate of < 70 b/min during CTA was associated with a significantly improved specificity and PPV.
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