[The role of transesophageal echocardiography in the detection of coronary anomalies and anatomical variations]

Abstract

Objectives: The aim of the study is to examine the role of transesophageal echocardiography (TEE) in the diagnosis of anomalies and anatomic variations of the coronary arteries.

Background: In the past, coronary angiography was the only method for diagnostic confirmation in all cases with coronary anomalies, but even during invasive procedures diagnostic difficulties could and can emerge. The different, varying origin of aberrant coronary arteries can prolong the diagnostic procedure, therefore can increase the irradiation time. So every method which seems to be suitable for diagnosis of suspected coronary anomalies can be helpful.

Methods: The origin and course of anomalous coronary arteries were studied by TEE and coronary angiography during a six-month period.

Results: We found 16 patients (2.8%) with coronary anomalies or variations by angiography, the diagnosis of which was technically difficult. Seven of these had TEE examination too. All seven anomalous origins proven angiographically and 2 of the 2 anomalous courses in the relation to the great vessels were diagnosed by TEE. (In two, the left circumflex originated from the right sinus of Valsalva, in two we found anomalous separate origin of left circumflex coronary artery from the left sinus, in another two a common ostium of the left anterior descending and circumflex artery from the left sinus and in one an accessory artery from the non-coronary sinus.)

Conclusions: TEE in a useful test to diagnose the origin of anomalous coronary arteries and confirming their course in relation to the great arteries.