Evaluation of proximal left coronary artery anatomy and blood flow using digital transesophageal echocardiography

Non-invasive evaluation of the proximal left coronary artery can be obtained by two-dimensional echocardiography [1–6]. Even if the feasibility of this kind of evaluation has been demonstrated, its clinical application has not yet obtained wide acceptance because of some difficulties that considerably hamper echocardiographic imaging of coronary arteries. First of all, review¬ing and evaluation of real time 2D Echo images of the coronaries is troublesome because of the cyclic movement of the heart that does not allow con¬tinuous monitoring of a tubular structure as small as the coronary artery; furthermore, the quality of echocardiographic images is very often poor and, therefore, does not allow accurate definition of the coronary boundaries.