A new approach to visualize the left main coronary artery using apical cross-sectional echocardiography.
Patients undergoing coronary arteriography were studied to evaluate the feasibility of use of cross-sectional echocardiography to detect the left main coronary artery. Visualization of the left main coronary artery from the cardiac apex was attempted using a cranial transducer angulation. With this approach, the left main coronary artery was adequately visualized in 27 of 35 consecutive patients (77 percent) who were prospectively evaluated; in 12 of the 27 the bifurcation was clearly seen. In 26 of the 27 patients cross-sectional echocardiography correctly assessed the patency of the left main coronary artery as judged with coronary angiography. One patient had a false positive echocardiographic study; there were no false negative studies. A comparison of the short axis versus apical cross-sectional techniques in another group of 30 patients revealed the superiority of the apical approach in visualization of the left main coronary artery and its bifurcation; combined use of both techniques allowed for a 93 percent (rate of) success. Thus, apical cross-sectional echocardiography permits visualization of the left main coronary artery and its bifurcation and, therefore, has the potential for detecting left main coronary obstructive lesions.
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis; D002932:Cineangiography; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D003331:Coronary Vessels; D004452:Echocardiography; D005189:False Positive Reactions; D006801:Humans; D008875:Middle Aged