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Eur J Cardiothorac Surg 2004;25:65-68
© 2004 Elsevier Science NL

High prevalence of unsuspected abdominal aortic aneurysms in patients hospitalised for surgical coronary revascularisation

^a Division of Vascular Medicine, University Hospital, CH-1011 Lausanne, Switzerland
^b Department of Cardiovascular Surgery, University Hospital, CH-1011 Lausanne, Switzerland
^c Department of Internal Medicine and Institute of Social and Preventive Medicine, University Hospital, CH-1011Lausanne, Switzerland

Received 12 May 2003; received in revised form 30 September 2003; accepted 20 October 2003.

^* Corresponding author. Department of Cardiovascular Surgery, University Hospital (Inselspital), CH-3010 Berne, Switzerland. Tel.: +41-31-632-2111; fax: +41-31-632-9766
e-mail: hendrik.tevaearai{at}insel.ch

Objectives: Prevalence of abdominal aortic aneurysms (AAA) is not exactly known among patients with coronary artery disease (CAD) who are considered for surgical revascularisation. We evaluated the value of screening AAA among coronary patients admitted in our cardiovascular surgery unit. Methods: Over a 24-month period, an abdominal echography was proposed to male patients aged 60 or more while hospitalised for surgical coronary revascularisation. Patients with previous investigation of the aorta were excluded. The aorta was considered aneurysmal when the anterior–posterior diameter was of 30 mm or more. Results: Three hundred and ninety-five consecutive patients all accepted a proposed abdominal echographic screening for AAA. Forty unsuspected AAA were detected (10.1%). The mean diameter was 38.9±1.3 mm. Four AAA were larger than 50 mm and considered for surgery after the CABG procedure. Surveillance was proposed to the other 36, especially the 10 patients with an AAA larger than 40 mm. Patients with AAA were significantly older than those without AAA (71.3±0.8 vs. 69.4±0.3 years, P<0.05). Smoking history (P<0.05) and hypertension (P<0.05) were also associated more frequently with AAA. More than 16% of the patients being smokers and suffering hypertension presented with unsuspected AAA. Conclusions: In-hospital screening of AAA is very efficient among patients with coronary artery disease. Therefore, patients with CAD may be considered for routine AAA screening.

Key Words: Abdominal aortic aneurysm • Screening • Coronary artery disease • Risk indicators • Cardiac surgery

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