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  1. M J Luckie,
  2. R S Khattar,
  3. D G Fraser
  1. Correspondence to Douglas G Fraser, Manchester Heart Centre, Oxford Road, Manchester M139WL, UK; dougfigraser{at}cmmc.nhs.uk

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We thank Dr Piscione for his interest in our article.1 We agree that the subgroup of patients with significant coronary artery disease and ischaemia, and an indication for urgent non-cardiac surgery, can prove difficult to manage. These patients are at increased risk of peri-operative cardiac complications, and where pre-operative revascularisation is …

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