DELINEATION OF EXTENDED LENGTHS OF CORONARY-ARTERIES BY MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Objectives. The purpose of this study was to evaluate the utility of m ultiplane transesophageal echocardiography in assessing the coronary a rtery tree. Background. Evaluation of coronary disease with single pla ne and biplane transesophageal echocardiography is limited to the very proximal vessels, The numerous views provided by multiplane imaging m ay enhance visualization of coronary arteries and detection of their a bnormalities. Methods. Intraoperative multiplane transesophageal echoc ardiography was performed in 45 consecutive adults who had recently un dergone angiography. Recordings were reviewed in blinded manner. Resul ts. We describe the coronary segments visualized with the different im aging planes and define new views. The left main coronary artery with its bifurcation was visualized in all 45 patients. Sensitivity and spe cificity for detection of coronary narrowings were 100% when results w ere compared with angiographic data. Visualization of proximal, mid an d distal segments of the left anterior descending coronary artery was possible in 69%, 31% and 16% of patients, respectively. Among patients in whom the proximal segment was visualized, sensitivity and spec ifi city for detection of significant narrowings were 80% and 100%. Proxim al, mid and distal portions of the left circumflex coronary artery wer e visualized in 80%, 51% and 20% of patients. Among patients in whom t he proximal portion was well seen, sensitivity and specificity were 89 % and 100%. The proximal, mid and distal portions of the right coronar y artery were visualized in 84%, 16% and 11% of patients. Among patien ts in whom the proximal segment was visualized, sensitivity and specif icity were 82% and 100%. Color Doppler examination was less useful bec ause it detected only 52% of all patients with proximal stenosis. Conc lusions. Multiplane transesophageal echocardiography al lows enhanced visualization of extended lengths of coronary arteries and the reliabl e identification of coronary artery abnormalities.