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Impact of CT incidental lung findings and pulmonary function on 3-year mortality after transcatheter aortic valve replacement (TAVR)

Heart & Lung·August 8Open Access
Respiratory SystemPractice changingAortic StenosisEmphysemaInterstitial Lung AbnormalitiesRetrospective Cohort StudyTranscatheter Aortic Valve ReplacementOlder Adult

Summary

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What was studied

This retrospective study evaluated whether incidental interstitial lung abnormalities (ILA) and reduced pulmonary function on preprocedural CT and spirometry predicted 3-year all-cause mortality in 572 patients undergoing transfemoral TAVR at a single center (2018–2021).

Key findings

ILA was found in 20.8% of patients and independently predicted 3-year mortality (HR 1.59, 95% CI 1.17–2.19; p=0.004); mortality was 57.6% in ILA patients vs. 36.4% in those without ILA. Reduced FVC (<80% predicted) also predicted mortality, but only in patients with ILA (p=0.015), not in those without (p=0.058).

Study limitations

Single-center retrospective design limits generalizability. Emphysema findings were noted as common but their independent prognostic impact was not separately reported. Causality between ILA and mortality cannot be established.

Clinical implications

Routinely review preprocedural TAVR CT scans for ILA, as its presence nearly doubles the hazard of 3-year death. In ILA-positive patients, add pulmonary function testing (FVC, DLCO) to guide follow-up and monitor for interstitial lung disease progression.

Related Questions

Explore related topics

How does interstitial lung disease affect outcomes after TAVR?Should pulmonary function testing be part of routine TAVR workup?What CT findings predict mortality in patients with severe aortic stenosis?

Publication Details

Year
2026
Journal
Heart &amp; Lung
Sample Size
n=572
Source
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