{
  "abstract": "Objective Pre procedural work up for transcatheter aortic valve implantation (TAVI) has traditionally required invasive coronary angiography (ICA). Following the development of a drugless radiographer led CT (RLCCT) service with good quality control metrics, 1 we investigated whether incorporation of coronary artery assessment into the TAVI CT protocol could reduce the need for ICA.Methods Two cohorts were analysed: pre-implementation (Jan 2017–Jun 2019) and post implementation (Jan 2023–Jun 2025) following RLCCT introduction. Service evaluation was registered with the clinical audit team, University Hospitals Plymouth, CA_2025-26-188. Data was evaluated using Radiology Information System (RIS) and an in house patient clinical information system (seeEHR). Uniform reporting included demographics (age, sex, BMI) and CAD-RADS score. ICAs < 24 months pre CT were included; those > 24 months were excluded.Results 2017 – 2019: Demographics: mean age 82, BMI 27, 53.93% male. 244/267 patients (91.4%) underwent ICA either within 24 months prior to CT TAVI or in the interval between CT and TAVI. Of these, 27 (11.1%) underwent revascularisation with PCI prior to TAVI.2023 – 2025: Demographics: mean age 80, BMI 28, 59.12% male. 117 of 362 patients (32.3%) underwent ICA: 81 (22.4%) prior to CT, 32 (8.8%) following CT, and 4 (1.1%) at the time of the TAVI procedure. The remaining 245 patients (67.7%) did not undergo pre procedural ICA (figures 1 and 2).Conclusions With advanced cardiac CT technology and experienced radiographers and reporters, RLCCT reduced ICA by 59% in increased surgical risk patients, improving safety, efficiency, and cost effectiveness of the TAVI pathway.Reference Morgan-Hughes G, et al. Drugless and radiographer led: the start of a new era for CT coronary angiography. Open Heart 2023;10(1):e002263–e002263. https://doi.org/10.1136/openhrt-2023-002263. By incorporating cardiac CT angiography into the TAVI CT protocol, can reduce the need for invasive coronary angiography amount by:40%50%60%Abstract 7 Figure 2Abstract 7 Figure 159%",
  "authors": [
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Ross Thorpe"
    },
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Joanna Bilak"
    },
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Carl Roobottom"
    },
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Grant Mitchell"
    },
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Louisa Mayo"
    },
    {
      "affiliations": [
        "University Hospitals Plymouth NHS Trust"
      ],
      "name": "Gareth Morgan-Hughes"
    }
  ],
  "title": "7 Radiographer led TAVI CT, incorporating coronary angiography, to minimise the use of invasive coronary angiography prior to TAVI",
  "uid": "594ae563-9d42-529b-987d-28fd0ba93b7c"
}