title: "Incidental findings" during TAVI work-up: more than just an inconvenience.
abstract: OBJECTIVE
  To characterise the clinical course of patients who had incidental findings on the CT aortogram (CTA) done as a transcatheter aortic valve implantation (TAVI) work-up investigation.
  
  
  RESULTS
  All patients who underwent CTA as a work-up investigation for TAVI were retrospectively recruited (n=295, 83±6.7 years) to identify those with an incidental finding. A total of 323 incidental findings were identified in 201 (68.1%) patients. Of those with incidental findings, 87 (43.3%) had at least one of immediate clinical significance. Within this group, fewer (52.9%) eventually had TAVI compared to those without incidental findings (63%). In patients going on to have TAVI, the time between CTA and TAVI was longer in those with incidental findings (median 96 vs. 81 days). At follow-up, overall mortality in those with incidental findings was higher than in those without (49.4% vs. 37.5%). In patients who underwent TAVI, there was a trend to increased mortality in those with incidental findings (34.8% vs. 21.4%, p=0.07).
  
  
  CONCLUSIONS
  Incidental findings were associated with a longer time to TAVI procedure, lower chance of eventually receiving TAVI as definitive therapy and a worse overall outcome. Such findings are clearly important and should be taken into account when delivering a contemporary TAVI service.
authors: Department of Cardiology, King's College Hospital, Denmark Hill, London, United Kingdom.
authors: Refai
authors: R
authors: Showkathali
authors: Arup
authors: A
authors: Sen
authors: Beth
authors: B
authors: Brickham
authors: Rafal
authors: R
authors: Dworakowski
authors: Olaf
authors: O
authors: Wendler
authors: Philip
authors: P
authors: MacCarthy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006801:Humans; D033162:Incidental Findings; D008297:Male; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome