CORONARY ANOMALIES DIAGNOSED WITH TRANSESOPHAGEAL ECHOCARDIOGRAPHY - COMPLEMENTARY CLINICAL-VALUE IN ADULTS

Introduction. Coronary arteriography remains a gold standard for the e valuation of coronary anatomy. In the case of anatomical anomalies, un derstanding of vessel course based upon a coronary angiogram may be di fficult. Transesophageal echocardiography is a noninvasive method allo wing tomographic visualization of proximal coronary arteries. Experien ce concerning its usefulness for the assessment of anomalous coronary arteries is limited. Material. Eleven patients with confirmed coronary anomalies studied between 1993-96 were identified in the cohort of th ose undergoing transesophageal echocardiography. Results. Transesophag eal echocardiography revealed potentially serious anomalies (origin of left or right coronary artery from contralateral aortic sinus) in 3 p atients and benign in 8. Coronary ostia and proximal course could be d elineated in all patients. Anatomical information was consistent betwe en methods, except for a separate origin of the left anterior descendi ng and circumflex artery, where the angiogram missed a very short comm on left main coronary artery in 2 patients. The relationship between t he coronary arteries, aorta and pulmonary trunk was better defined by the echocardiogram. Doppler flow analysis allowed us to exclude anomal y-related flow disturbances. Conclusions. Transesophageal echocardiogr aphy can be considered as a noninvasive technique with the potential f or anatomical and functional evaluation of anomalous proximal coronary arteries and deserves a routine use whenever such a condition is susp ected. This approach may simplify invasive procedures in this patient group.