Embolic Events After Computed Tomography Contrast Injection in Patients With Interatrial Shunts: A Cohort Study.
J Thorac Imaging
; 37(5): 331-335, 2022 Sep 01.
Article
en En
| MEDLINE
| ID: mdl-35797552
ABSTRACT
BACKGROUND:
Patients with interatrial shunts (patient foramen ovale/atrial septal defect) are potentially at increased risk for paradoxical air embolism following computed tomography (CT) scans with intravenous (IV) contrast media injection. IV in-line filters aim to prevent such embolisms but are not compatible with power injection required for diagnostic CT.PURPOSE:
The purpose of this study was to determine whether the incidence of paradoxical embolism to the heart and brain in patients with an interatrial shunt is higher compared with controls within 48 hours following injection of IV contrast media without IV in-line filter.METHODS:
This is a retrospective cohort study conducted at a large tertiary academic center, which included a total of 2929 consecutive patients who underwent 8983 CT scans with IV contrast media injection between July 1, 2000 and April 30, 2018. Diagnosis of an interatrial shunt was confirmed by transthoracic or transesophageal echocardiography. Incidence and risk of cardiac embolic events (new troponin elevation, >0.1 ng/mL) and neurological embolic events (new diagnosis of stroke/transient ischemic attacks) were evaluated.RESULTS:
Among the 2929 patients analyzed (mean±SD age, 61±14 y), 475/2929 (16.2%) patients had an interatrial shunt. After applying the exclusion criteria, new elevated troponin was found in 8/329 (2.4%; 95% confidence interval [CI] 1.1-4.7) patients with an interatrial shunt compared with 25/1687 (1.5%; 95% CI 0.9-2.2) patients without an interatrial shunt. New diagnosis of stroke occurred in 2/169 (1%; 95% CI 0.3-4.2) of patients with an interatrial shunt compared with 7/870 (0.8%; 95% CI 0.4-1.7) without interatrial shunt.CONCLUSION:
Among patients with echocardiographic evidence of an interatrial shunt, IV CT contrast administration without an in-line filter does not increase the incidence of cardiac or neurological events.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Embolia
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Defectos del Tabique Interatrial
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Thorac Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2022
Tipo del documento:
Article