RESUMO
BACKGROUND: There is a scarcity of data on the prevalence of abnormal findings on preprocedural computed tomography (CT) before aortic valve replacement (AVR) in patients with aortic stenosis (AS). METHODS: Among consecutive 593 patients with severe AS who were planned to undergo AVR, we evaluated the prevalence of clinically significant incidental noncardiac findings on preprocedural CT. Clinically significant incidental noncardiac findings were defined as newly detected abnormalities that required therapy, consultation for expert, further investigation, or clinical follow-up. RESULTS: The mean age was 82.0â¯years and 39.5â¯% of the patients were men. Of those, 78.4â¯% of the patients were treated with transcatheter aortic valve implantation (TAVI) and 21.6â¯% of the patients were treated with surgical AVR (SAVR). There were 271 clinically significant incidental noncardiac findings in 227 patients (38.3â¯%) including 2.5â¯% of malignancy. The prevalence of clinically significant incidental noncardiac findings were higher in the TAVI group than in the SAVR group (40.2â¯% versus 31.3â¯%). The prevalence of clinically significant incidental noncardiac findings were lower in patients under 60â¯years of age (10.0â¯%) than in patients over 60â¯years of age (60-69â¯years: 40.0â¯%, 70-79â¯years: 34.3â¯%, 80-89â¯years: 39.7â¯%, and ≥90â¯years: 42.1â¯%). CONCLUSIONS: Clinically significant incidental noncardiac findings were newly identified on preprocedural CT in approximately 40â¯% of patients with severe AS undergoing AVR including 2.5â¯% of malignancy.
RESUMO
Patent foramen ovale (PFO) complicated with carcinoid heart disease (CHD) can cause severe hypoxia and worsening clinical conditions. We report the case of a patient with CHD in poor general condition with multiple severe valve regurgitations and PFO, who underwent successful percutaneous closure of the PFO.