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CC BY 4.0 · Thorac Cardiovasc Surg
DOI: 10.1055/a-2708-3100
Original Thoracic

Computed Tomography Reduces Complications in Surgical Aortic Valve Replacement

Authors

  • Liliane Zillner

    1   Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Julian Heidtmann

    1   Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Markus Mach

    1   Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Richard Nolz

    1   Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Christian Loewe

    2   Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria, Medical University of Vienna, Vienna, Austria (Ringgold ID: RIN27271)

  • Alfred Kocher

    3   General Hospital Vienna, Vienna, Austria

  • Daniel Zimpfer

    4   Dept. of Cardiothoracic Surgery, Medical University Vienna, Vienna, Austria

  • Martin Andreas 

    5   Cardiac Surgery, Medical University of Vienna, Vienna, Austria
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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.



Publication History

Received: 15 May 2025

Accepted after revision: 20 September 2025

Accepted Manuscript online:
24 September 2025

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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