COMPLEMENTARY ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY TO CORONARY ANGIOGRAPHY IN THE ASSESSMENT OF CORONARY-ARTERY ANOMALIES

Objectives-To examine the role of transoesophageal echocardiography in the assessment of patients with coronary artery anomalies. Background -Coronary artery anomalies are difficult to detect clinically. Most ar e benign but some may produce symptoms that can be life threatening. U ntil recently the non-invasive assessment of coronary artery anomalies has been limited. Methods-The data base of transoesophageal echocardi ographic studies performed between September 1988 and April 1991 were reviewed to identify all cases of coronary artery anomalies. There wer e six patients with such anomalies who had also had coronary angiograp hy. The findings of these two imaging techniques were analysed to dete rmine whether transoesophageal echocardiography added useful data in t hese cases. Results-Of the six patients, the coronary anomaly was disc overed during angiography in four patients, during a transthoracic ech ocardiographic study in one patient, and as an incidental finding in t he other patient. Aberrant origins of the left coronary artery were de tected in two patients, and coronary artery fistulae were present in t he other four. Transoesophageal echocardiography provided unique infor mation on the course of an aberrant left coronary artery in one patien t and the precise location of drainage sites of coronary artery fistul as in three patients. Conclusion-Transoesophageal echocardiography was complementary to angiography in the assessment of coronary artery ano malies. It can locate and delineate the course of an ectopic coronary artery and the drainage site of a coronary fistula. These anatomical d ata can be crucial to the management of these patients.