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Thoracic Malignancies and Pulmonary Nodules in Patients under Evaluation for Transcatheter Aortic Valve Implantation (TAVI): Incidence, Follow Up and Possible Impact on Treatment Decision

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the treatment of choice in patients with severe aortic valve stenosis who are not eligible for operative replacement and an alternative for those with high surgical risk. Due to high age and smoking history in a high proportion of TAVI patients, suspicious findings are frequently observed in pre-procedural chest computer tomography (CCT). METHODS: CCT scans of 484 consecutive patients undergoing TAVI were evaluated for incidentally discovered solitary pulmonary nodules (SPN). RESULTS: In the entire study population, SPN ≥ 5 mm were found in 87 patients (18%). These patients were compared to 150 patients who were incidentally collected from the 397 patients without SPN or with SPN 8 mm (p = 0.328) were significant predictors of overall survival. CONCLUSIONS: Despite the high prevalence of SPNs in this single center TAVI cohort lung cancer incidence at midterm follow-up seems to be low. Thus, aggressive diagnostic approaches for incidentally discovered SPN during TAVI evaluation should not delay the treatment of aortic stenosis. Unless advanced thoracic malignancy is obvious, the well documented reduction of morbidity and mortality by TAVI outweighs potentially harmful delays regarding further diagnostics. Standard guideline-approved procedure for SPN can be safely performed after TAVI.

Titel: Thoracic Malignancies and Pulmonary Nodules in Patients under Evaluation for Transcatheter Aortic Valve Implantation (TAVI): Incidence, Follow Up and Possible Impact on Treatment Decision
Verfasser: Schmidt, Lars Henning GND
Vietmeier, Benedikt
Kaleschke, Gerrit Tobias GND
Schülke, Christoph GND
Görlich, Dennis
Schliemann, Christoph GND
Keßler, Torsten GND
Schulze, Arik Bernard GND
Buerke, Boris Tobias GND
Kümmel, Andreas GND
Thrull, Michael
Wiewrodt, Rainer Gerhard GND
Baumgartner, Helmut GND
Berdel, Wolfgang E. GND
Mohr, Michael
Organisation: FB 05: Medizinische Fakultät
Dokumenttyp: Artikel
Medientyp: Text
Erscheinungsdatum: 12.05.2016
Publikation in MIAMI: 26.09.2016
Datum der letzten Änderung: 26.09.2016
Quelle: PLoS ONE 11 (2016) 5, e0155398, 1-14
Fachgebiete: Medizin und Gesundheit
Lizenz: CC BY 4.0
Sprache: Englisch
Anmerkungen: Finanziert durch den Open-Access-Publikationsfonds 2015/2016 der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format: PDF-Dokument
URN: urn:nbn:de:hbz:6-24269609381
Permalink: https://nbn-resolving.org/urn:nbn:de:hbz:6-24269609381
DOI: 10.1371/journal.pone.0155398
ISSN: 1932-6203
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