[Transesophageal echocardiography in the assessment of coronary artery anatomy and blood flow].

Proximal coronary artery anatomy and coronary blood flow was evaluated by transesophageal echocardiography in 41 consecutive patients without coronary artery disease. The left main coronary artery was visualized in 37 patients (90%), the left anterior descending coronary artery in 20 (48%), the left circumflex artery in 16 (39%) and the right coronary artery in 7 (17%). The image quality was optimal in 58% of patients in left main coronary artery, 29% in left anterior descending coronary artery, 24% in left circumflex artery and 5% in right coronary artery. Transesophageal Pulsed Doppler echocardiography evaluation of blood flow velocity in the left coronary artery was obtained in 37% of patients. Velocity flow pattern was biphasic with greater diastolic component and smaller systolic one (average peak flow velocity of 47.5 +/- 16.6 cm/seg during diastole and 23.1 +/- 9.5 cm/seg during systole). Coronary blood flow was detected by transesophageal color Doppler echocardiography in 51% of patients in left main coronary artery, 24% in left anterior descending coronary artery, 19% in left circumflex artery and 2% in right coronary artery. We conclude that transesophageal echocardiography provides better and more accurate visualization of proximal coronary arteries than transthoracic echocardiography, but technical limitations still remain to detect and evaluate coronary artery anatomy and coronary blood flow in a large number of patients.