Detection of left coronary artery stenosis by transoesophageal echocardiography

The ability of transoesophageal echocardiography to visualize the left coronary artery was retrospectively analysed in 60 consecutive patients without clinical evidence of coronary artery disease. The left main coronary artery was visualized in 56 patients, the proximal circumflex in 34 patients and the proximal anterior descending artery in nine patients. Patency of these arteries was established in all these patients. Subsequently, a prospective study was undertaken in 23 patients with angiographically proven left coronary artery disease. Both the left main coronary artery and the circumflex artery were adequately visualized with transoesophageal echocardiography in all 23 patients, whereas the anterior descending artery was identified in three patients. The extent of stenosis in the left main coronary artery and the circumflex artery was correctly diagnosed in 18 patients. In five patients the degree of stenosis was overestimated. These findings indicate the potential of transoesophageal echocardiography to detect or exclude stenosis of both the left main coronary artery and circumflex artery.