A novel technique to detect total occlusion in the right coronary artery using retrograde flow by transthoracic Doppler echocardiography.
BACKGROUND
We hypothesized that detection of reverse flow in the distal right coronary artery (d-RCA) and the inferior septal branches (ISB) by transthoracic Doppler echocardiography (TTDE) would be useful for noninvasive diagnosis of the occluded right coronary artery (RCA).


METHODS
Coronary angiography and TTDE were performed on 129 patients. Antegrade flows in the d-RCA and the ISB were defined as directions from the base to the apex in the posterior sulcus and from anterior to inferior in the inferior septum, respectively. Retrograde flow was defined as an inverse direction.


RESULTS
Retrograde flow was obtained by TTDE in 14 patients (d-RCA:11, ISB:3) of 18 patients with occluded RCA. The sensitivity and the specificity for identification of occluded RCA were 100% and 97.8%, respectively.


CONCLUSIONS
Detection of reverse flow in the d-RCA and the ISB using TTDE is a useful method for the noninvasive diagnosis of occluded RCA.
Department of Internal Medicine and Cardiology, Osaka City University Medical School, Japan.
Ryo
R
Otsuka
Hiroyuki
H
Watanabe
Kumiko
K
Hirata
Kotaro
K
Tokai
Takashi
T
Muro
Takeshi
T
Hozumi
Minoru
M
Yoshiyama
Junichi
J
Yoshikawa
D000368:Aged; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method