Diagnostics of Main Coronary Artery Stenoses and Occlusions: Multiplane Transoesophageal Doppler Echocardiographic Assessment

Vrublevsky, Alexander V.; Boshchenko, Alla A.; Карпов, Р. С.

doi:10.1053/euje.2001.0092

Cited by 23 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 In a comparative study of 94 patients, a high correlation was found between the results of TEE and quantitative coronary angiography for the LMCA, LAD, LCx and RCA. 6 Also, a good linear correlation was found between TEE derived luminal percent area stenosis, using a modified continuity equation, and quantitative angiography. 6 In addition, three dimensional transesophageal echocardiography was found to be successful in delineating normal and stenotic proximal coronary arteries.…”

Section: Discussionmentioning

confidence: 97%

“…6 Also, a good linear correlation was found between TEE derived luminal percent area stenosis, using a modified continuity equation, and quantitative angiography. 6 In addition, three dimensional transesophageal echocardiography was found to be successful in delineating normal and stenotic proximal coronary arteries. 7,8 The LMCA, LAD, LCx and RCA were visualized in 100%, 100%, 98%, and 72% of the patients, respectively, with a sensitivity and specificity in detecting significant stenosis of 84% and 97%.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Failure of multiple coronary angiographies to identify left main coronary artery disease in a patient diagnosed by transesophageal echocardiography

Ahmari

Idris

Amri

et al. 2005

European Journal of Echocardiography

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Failure of multiple coronary angiographies to identify left main coronary artery disease in a patient diagnosed by transesophageal echocardiography

Ahmari

Idris

Amri

et al. 2005

European Journal of Echocardiography

View full text Add to dashboard Cite

show abstract

“…The optimal techniques are IVUS and FFR measurements, however these techniques are extremely expensive, not widely available, and require special training. Non-invasive techniques like TEE or TTDE using a high frequency transducer are useful for noninvasive evaluation of flow velocity dynamics in the LM [12,20-22,32]. Doppler-TTE is a simple, widely-used, and noninvasive procedure that does not require lengthy preparation and post-examination observation, therefore can be used for routine screening of patients with known ambiguous LM as adjunct to other invasive or non-invasive diagnostic modalities.…”

Section: Discussionmentioning

confidence: 99%

Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

Ruzsa

Pálinkás

Forster

et al. 2011

Cardiovasc Ultrasound

View full text Add to dashboard Cite

Backgroundthe clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50%) of the left main coronary artery (LM). The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE) peak diastolic flow velocity (PDV) and intravascular ultrasound (IVUS) measurements in the assessment of angiographically borderline LM lesions.Methods27 patients (mean age 64 ± 8 years, 21 males) with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA) and plaque burden (PB) measurement and routine quantitative coronary angiography (QCA) with diameter stenosis (%DS) and area stenosis (%AS) assessment in all. During TTDE, resting PDV was measured in the LM.Resultsinterpretable Doppler signal could be obtained in 24 patients (88% feasibility); therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p < 0.05) and plaque burden (r = 0.51, p < 0.05). Using a velocity cut-off of 112 cm/sec TTDE showed a 92% sensitivity and 62% specificity to identify IVUS-significant (MLA < 6 mm2) LM stenosis.ConclusionIn angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

show abstract

“…Transesophageal Doppler evaluation of coronary blood flow may help to detect the coronary arteries stenoses. 4 The left main coronary artery peak diastolic flow velocity of 1.4 m/s can be considered a criteria for hemodynamically significant coronary stenosis. Another Doppler criterion 5 suggesting the presence of a significant coronary stenosis is a ratio of Ն2.0 for maximal blood flow velocity at the site of the stenosis to the prestenotic flow velocity.…”

mentioning

confidence: 99%

Surgery for Anomalous Origin of Left Coronary Artery From Pulmonary Artery: The Utility of Intraoperative Transesophageal Echocardiography

Gadhinglajkar

Sreedhar²

2009

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

A 51-yr-old female patient, presented with 3-yr symptoms of intermittent chest pain and dyspnea New York Heart Association class II, which progressed to class IV since 1 mo.She was provisionally diagnosed as having anomalous origin of left coronary artery from pulmonary artery (ALCAPA) and severe mitral regurgitation (MR) on transthoracic echocardiography. Preoperative catheter studies and coronary angiography confirmed the diagnosis and revealed left ventricular (LV) ejection fraction of 46%. She was scheduled to undergo surgery for relocation of the left coronary artery (LCA) and mitral valve replacement. After induction of anesthesia, her heart was examined using transesophageal echocardiography (TEE). Withdrawing the probe slightly from the midesophageal (ME) five-chamber view and turning it to the right revealed a large retrograde-filling LCA connected to the main pulmonary artery (MPA) (Fig. 1). The flow was turbulent during the early part of systole and red (towards the transducer) during the rest of the cardiac cycle. ALCAPA, connected to the posterior sinus of the MPA, could also be visualized in the same view as in Figure 1 and also in the modified right ventricular inflow outflow view at 90 -100 degrees after probe anteflexion (Video 1; please see video clips available at www.anesthesiaanalgesia.org). The distance between the midpoint of the empty aortic sinus and attachment of the ALCAPA on the posterior sinus of the MPA was 13.9 mm. Antegrade blood flow was observed in the dilated right coronary artery (RCA) (Video 2; please see video clips available at www.anesthesia-analgesia.org), which was 6.2 mm in diameter. Multiple unusual color flow Doppler signals were detected within the interventricular septum in aortic valve long axis view, believed to represent high flow septal coronary collaterals between the RCA and the ALCAPA. ME fourchamber view revealed thickened mitral valve leaflets, calcific papillary muscles and enlarged LV. Features of severe MR were also present (Vena contracta 7 mm in ME long axis view; systolic flow reversal in the right and left superior pulmonary vein). LV dilation (LV end-systolic dimension 48 mm) and hypokinesia of the anterolateral wall were observed on transgastric navigation. On establishment of cardiopulmonary bypass (CPB) and cardioplegia delivery, the LCA was disconnected from the MPA, along with a button of tissue around it, and was relocated onto the aorta. The mitral valve was replaced with size-28 Star Edward prosthesis. In the post-CPB period, the ALCAPA and the RCA could be seen flowing antegrade from the aortic root in modified five-chamber view (Fig. 2). The LCA diastolic flow velocity on pulsed wave Doppler, measured in the aortic valve short axis view at the sector angle between 10 and 30 degrees, was 0.7 m/s. It remained constant on Doppler interrogation up to 7-8 mm in the course of the vessel from its attachment to the aorta. The LV contractility had improved and no fresh regional wall motion abnormalities were found. The mitral valve prosthesis was fu...

show abstract

Diagnostics of Main Coronary Artery Stenoses and Occlusions: Multiplane Transoesophageal Doppler Echocardiographic Assessment

Abstract: Transoesophageal Doppler evaluation of coronary blood flow with application of a modified continuity equation is an accurate, non-invasive method of coronary arteries stenoses diagnostics.

Cited by 23 publications

References 13 publications

Failure of multiple coronary angiographies to identify left main coronary artery disease in a patient diagnosed by transesophageal echocardiography

Failure of multiple coronary angiographies to identify left main coronary artery disease in a patient diagnosed by transesophageal echocardiography

Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

Surgery for Anomalous Origin of Left Coronary Artery From Pulmonary Artery: The Utility of Intraoperative Transesophageal Echocardiography

Contact Info

Product

Resources

About