Preoperative Computed Tomography is Associated with Reduced In-Hospital Complications in Aortic Valve Surgery.

OBJECTIVE

To assess the efficacy of preoperative full aortic computed tomography (CT) to reduce complications during surgical aortic valve replacement (SAVR).

METHODS

A single-center retrospective study examined all SAVR procedures from 2013 to 2015, comparing outcomes between surgeries planned with CT and those without. The study assessed how CT imaging adapted surgical methods, including cannulation and the possibility of switching from SAVR to interventional therapy. The analysis primarily focused on the occurrence of in-hospital complications.

RESULTS

Out of 359 patients analyzed, those who received presurgical CT (n = 305, complications = 53; 17%; EuroSCORE = 1.8) had fewer in-hospital complications compared with the non-CT group (n = 54, complications = 17; 32%; EuroSCORE = 1.8), with a statistically significant difference (p = 0.016). Patients in the CT group had a 15% absolute risk reduction and a number needed to treat of 7 to avoid one in-hospital complication.

CONCLUSION

CT is associated with reduced in-hospital complications in SAVR patients and could enhance patient outcomes when used in preoperative planning. This supports the recommendation for incorporating CT into routine preoperative assessment to enable personalized surgical strategies, potentially including a shift to transcatheter treatments when indicated.