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).
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).
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.
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.
