ABSTRACT
The visualization of coronary arteries by transthoracic two-dimensional echocardiography has been used for over 10 years. In many cases, the imaging quality is too poor to allow an anatomic evaluation. During the last few years, transesophageal echocardiography has been shown to provide optimal imaging quality in virtually all patients and of all cardiac structures including the coronary arteries. The purpose of this study was to test the ability of transesophageal echocardiography in the visualiation of the coronary arteries and assessment of coronary blood flow by transesophageal two-dimensional pulsed Doppler echocardiography. We Studied 285 patients, 91 men and 194 women, aged 16 to 81 year(mean 50.6 year men, mean 54.2 year women). We have been used a 5-MHz phased array transducer with incorporated color-coded Doppler. The left main coronary artery was visualized 95.1%, left circumflex artery 27.4, left anterior descending artery 21.4% and the main stem of the proximal right coronary artery 45.1%. The time-sequential left anterior descending artery flow pattern generally consisted of a small late systolic component and a large diastolic component. The peak flow velocity in the proximal left anterior descending artery during diastole was 40.8+/-8.0cm/sec(integrity 7.6+/-0.9) and during late systole was 18.5+/-5.5cm/sec(integrity 2.9+/-0.9). There were no complications during and after examination. This study suggests that transesophageal color-coded Doppler two-dimensional echocardiography appers to be a feasible noninvasive technique for imaging the proximal left coronary artery and the left anterior descending artery flow is detectable from the transesophageal approach.