title: Thoracic Incidental Findings in Preoperative Computed Tomography Evaluation for Transcatheter Aortic Valve Implantation (TAVI).
abstract: BACKGROUND
  Many older patients with aortic stenosis are excluded from surgical intervention due to multiple comorbidities. For these patients, transcatheter aortic valve implantation (TAVI) is a viable treatment alternative. Cardiothoracic computed tomography (CT) provides detailed anatomic assessment of the aortic root structures for patient selection, preprocedural planning, and intraoperative decision-making; however, nonaortic incidental findings are frequently detected. The prevalence and clinical significance of these findings have not been well described.
  
  
  METHODS
  This retrospective study examined incidental findings in 209 consecutive patients (96 women and 113 men; mean age, 70 y) with aortic stenosis undergoing preoperative cardiothoracic CT evaluation for TAVI during a 3-year period. Incidental findings were recorded, and medical records were reviewed for follow-up diagnostic examinations.
  
  
  RESULTS
  Incidental findings, both significant and nonsignificant, were observed in 85.6% of patients (179/209). Noncalcified pulmonary nodules were the most common incidental finding occurring in 59/209 (28.2%) patients, followed by pleural effusion and emphysema both of which occurred in 34/209 (16.3%) patients, respectively.
  
  
  CONCLUSIONS
  Cardiothoracic CT obtained for evaluation before TAVI has a high frequency of incidental findings.
authors.affiliation: *Johns Hopkins Medical Institution †University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Amira F
authors.initials: AF
authors.lastname: Hussien
authors.forename: Jean
authors.initials: J
authors.lastname: Jeudy
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Kligerman
authors.forename: Charles S
authors.initials: CS
authors.lastname: White
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement