CT imaging prior to transcatheter aortic valve implantation in the UK

ObjectiveThis cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.Methods408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-...

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Bibliographic Details
Published in:Open heart 2020-04, Vol.7 (1), p.e001233
Main Authors: Harries, Iwan, Weir-McCall, Jonathan R, Williams, Michelle C, Shambrook, James, Roditi, Giles, Bull, Russel, Morgan-Hughes, Gareth J, Nicol, Edward D, Moss, Alastair J
Format: Article
Language:English
Subjects:
Aortic Valve - diagnostic imaging
Aortic Valve - physiopathology
Aortic Valve - surgery
Beta blockers
Cardiology
Cardiovascular disease
Coronary vessels
Cross-Sectional Studies
Health Care Surveys
Healthcare Disparities - trends
Heart surgery
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - physiopathology
Heart Valve Diseases - surgery
Hospitals, High-Volume - trends
Hospitals, Low-Volume - trends
Humans
Polls & surveys
Practice Patterns, Physicians' - trends
Predictive Value of Tests
Radiation Dosage
Radiation Exposure
Response rates
Society
Tomography, X-Ray Computed - trends
Transcatheter Aortic Valve Replacement - trends
United Kingdom
Valvular Heart Disease
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Summary:ObjectiveThis cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.Methods408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.Results47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477–954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).ConclusionsThis national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.
ISSN:2053-3624
2398-595X
2053-3624
DOI:10.1136/openhrt-2019-001233