The detection of coronary ostial lesions by intraoperative transesophageal echocardiography: report of a case.

Transesophageal echocardiography (TEE) is a valuable diagnostic tool for providing clear images of the proximal coronary arteries. We describe herein the case of an elderly man in whom dissection and an atherosclerotic plaque in the proximal coronary arteries were demonstrated by TEE during combined coronary artery bypass grafting and aortic valve replacement. Thus, retrograde cardioplegia was employed, whereby trauma to the coronary ostia was avoided.