Backgrounds: Abdominal aortic aneurysm (AAA) is a potentially fatal disease when ruptured. Conversely, the study of the abdominal aorta is not routinely included in the echocardiography protocol, although it can be performed quickly and easily for screening of AAA. In the western country, the prevalence of AAA during transthoracic echocardiography (TTE) is 0.82% – 4.6% in an unselected population. The aim of this study was to determine the clinical utility of TTE as a screening method for the detection of AAA in Korean population.
Methods: From March to May 2009, all the patients who were scheduled for TTE were enrolled. At the end of each TTE exam, abdominal aorta was evaluated at the level above the renal artery bifurcation. AAA was defined as an abdominal aorta diameter���30 mm.
Results: Total 6267 patients were screened, and among them, the abdominal aortas were visualized in 4939 patients (78.8%). AAA was diagnosed in 27 patients (0.5%) (M:F= 23:4, mean age=66.5짹12.3 years, mean size=42.6짹16.3 mm). Five patients were under 60 years, and 22 patients were over 60 years. The prevalence was 0.97% in men and 0.16% in women in overall population, and 1.2% in men over 60 years and 0.27% in women over 60 years. Presence of AAA was associated with male gender (p<0.05) and older age in men (p=0.024) and older age in women (p=0.012). Of the 27 patients, AAA was previously known in 16 (59.3%), and eleven patients (0.22%) were newly diagnosed as AAA. Among 11 patients with a previously unknown AAA, aortic diameter of one patient exceeded 50mm. He underwent endovascular aneurysm repair (EVAR)
Conclusions: Screening of AAA by TTE is easy and feasible. Even though prevalence of AAA in unselected patients is very low, since detection of life-threatening but asymptomatic AAA may save lives, opportunistic examination of the abdominal aorta during routine TTE, which involves little time and no additional cost, would appear to be effective, at least in patients over 60 years, especially in men.