Computed Tomography Reduces Complications in Surgical Aortic Valve Replacement

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 pre-surgical CT (n=305, complications = 53; 17%; EuroSCORE = 1.8)) had fewer in-hospital complications compared to 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 (NNT) of 7 to avoid one in-hospital complication. Conclusions: 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. Keywords Aortic valve replacement, perioperative stroke, computed chest tomography, in-hospital complications, full aortic computed tomography.