Assessment of Left Main Coronary Stenosis by Transesophageal Echocardiography
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 6
Abstract
Introduction: Coronary angiography is, and remains, the gold standard for evaluating the left main coronary artery (LMCA) stenosis. Transthoracic echocardiography has been shown to be of value in demonstrating LMCA anatomy and arteriosclerotic lesions. Aim: The purpose of the study was the utility of transesophageal echocardiography in assessing LMCA stenosis. Methods: The study was conducted in the Department of Cardiology, Government Rajaji Hospital, Madurai. Transesophageal echocardiography was done and LMCA visualized at midesophageal transverse view at the base of the heart and the level of the left sinus of Valsalva and flow was recorded with pulsed wave Doppler. Results: We studied 25 patients of whom 20 were male, and 5 were female. 16 patients presented as inferior wall myocardial infarction, six as anterior wall myocardial infarction, and three as stable angina. The mean size of the LMCA at the level of the ostium is 3.27 mm + 0.6 mm, shaft level is 3.7 mm + 0.74 mm, and at the level of bifurcation is 2.87 mm + 0.34 mm. The length of the LMCA was 7 mm + 1.83 mm. All patients show stenosis of the LMCA and turbulence. The diastolic flow velocity before the stenosis was 84 cm/s + 16.7 cm/s and after the level of stenosis was 343 cm/s + 43.4 cm/s. The diastolic flow velocity ratio between LMCA and LAD is 1.24%. All patients underwent quantitative coronary angiogram and showed LMCA stenosis. Conclusion: Transesophageal Doppler assessment of coronary blood flow is a highly sensitive and specific non-invasive method in the diagnosis of stenotic and occlusive atherosclerosis of the main coronary arteries.
Authors and Affiliations
C Balachandran, T Viswanathan, M Ravichandran Edwin, A S Arul, Heber Anandan
Keywords
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