Should we screen patients undergoing thoracic surgery for aortic stenosis pre-operatively?

Aortic stenosis (AS) is the most prevalent valvular heart disease in the elderly. Depending on the severity of the disease, an intervention is required through either surgical or percutaneous approach. Presence of AS adds significant morbidity and mortalities to non-cardiac pathologies. Current guidelines recommend postponing non-cardiac surgery in individuals with severe AS; however, this may not always be possible in thoracic surgery as having to postpone or cancel a surgery may be the difference between patients receiving life-prolonging treatment or not. Screening for AS therefore has a role in detecting asymptomatic patients prior to their development of severe, symptomatic AS which can allow us to intervene prior to further disease progression. This, as a result, serves as a mean of potentially prolonging patients' wellbeing and have a satisfactory perioperative outcome. In this paper, we evaluate the role of screening in AS in patients undergoing thoracic surgery and the possibility of combined aortic valve intervention and resection of lung cancer.