Cardiac Screening Before Aortic Surgery

Cardiac Screening Before Aortic Surgery Douglas J. Wirthlin and Richard R Cambria The incidence of concomitant coronary artery disease (CAD) and aortic pathol­

ogy is such that few would dispute the need of some level of cardiac evaluation prior to aortic surgery. Over half (40-60%) of patients presenting with abdominal aortic aneurysm (AAA) harbor CAD and less than 10% have normal coronary anatomy. More importandy, approximately one third of patients present with severe but sur­ gically correctable cardiac disease, and of these patients, half (15% of total patients) demonstrate few to no clinical signs of CAD.1