Transesophageal echocardiographic evaluation of left main coronary artery.

Transesophageal echocardiography (TEE) demonstrated the left main coronary trunk in 30 of 32 patients. Of these 30 patients, 10 had angiographically normal and 20 stenotic left main coronary arteries. The TEE study revealed no stenosis in 9 of 10 patients with normal left main trunks and atherosclerotic lesions in all 20 patients with stenotic left main trunks. TEE demonstrated additional areas of stenosis in the left main coronary artery in 3 patients, which included ostial lesions in 2 patients. These features were not observed by angiography. Furthermore, when compared with angiography, TEE overestimated severity of stenosis in 4 patients. In conclusion, TEE is a useful test in demonstrating normal as well as stenotic left main coronary trunks.