Left main coronary arterial patency assessed with cross-sectional echocardiography

Abstract

To assess the ability to visualize the left main coronary artery with cross-sectional echocardiography, 123 patients scheduled to undergo coronary arteriography were studied prospectively. The left main coronary artery was visualized with a phased array sector scanner. Coronary arteriography revealed a normal left main coronary artery in 108 of the 123 patients and more than 50 percent stenosis of this vessel in 15 patients. The left main coronary artery was adequately visualized with crosssectional echocardiography in 62 (57 percent) of the 108 patients with an arteriographically normal artery and in 9 (80 percent) of 15 patients with more than 50 percent stenosis of this vessel. Cross-sectional echocardiography indicated a normal left main coronary artery In 59 of the 108 patients with a normal left main vessel on coronary arteriography. In three patients thought to have greater than 50 percent stenosis of the distal left main coronary artery on cross-sectional echocardiography, coronary arteriography revealed significant stenosis of the proximal left anterior descending coronary artery and a normal left main coronary artery. In all nine patients with more than 50 percent stenosis of the left main coronary artery on coronary arteriography and adequate visualization of this vessel on cross-sectional echocardiography, the latter technique revealed narrowing of the lumen of this vessel. It is concluded that: (1) When the left main coronary artery is adequately visualized with crosssectional echocardiography, the presence or absence of more than 50 percent stenosis of this vessel can be assessed. (2) Stenosis of the proximal left anterior descending coronary artery may mimic a distal left main coronary arterial stenosis. (3) Studies on larger numbers of subjects with left main coronary artery disease will help to delineate further the role of cross-sectional echocardiography in evaluating a patient with suspected disease of this artery.