RELIABILITY OF DIGITAL TRANSESOPHAGEAL EC HOCARDIOGRAPHY FOR THE EVALUATION OF THE LEFT CORONARY-ARTERY

Fifty consecutive patients (mean age 56 years) were examined to evalua te the reliability of transesophageal echocardiography in the evaluati on of the left proximal coronary artery. Results of 28 cases were comp ared to selective coronary angiography. Echocardiography was able to v isualize the left main artery for the length of 1.0 +/- 0.6 cm in all patients (100%), the left circumflex artery for maximal 3.1 +/- 1.4 cm in 86% and the left anterior descending artery as long as 2.3 +/- 0.9 cm in 58%. The intraluminal diameter of the most proximal localized s egments measured by echocardiography and angiography in the LAO and RA G-projection was in terms of the left main artery 4.1 +/- 0.9 mm, 4.1 +/- 0.9 mm and 4.0 +/- 0.9 mm (n.s.), of the left circumflex artery 2. 8 +/- 0.5 mm, 3.3 +/- 0.8 mm and 3.3 +/- 0.9 mm (n.s.) and of the left anterior descending artery 3.0 +/- 0.8 mm, 3.4 +/- 0.7 mm, and 3.6 +/ - 1.0 mm (n.s.). In respect of detection of coronary artery stenoses i n correspondence to the coronary angiogram sensitivity was 81%, specif icity 93% and positive predictive accuracy 86%. Quantitative analyses of the coronary anatomy and the correlation to angiography could contr ibute to the validation of transoesophageal echocardiography.