Free-hand four-dimensional echocardiography: a diagnostic tool in coronary artery disease.

Direct echocardiographic visualization of coronary arteries has been difficult due to the inherent problems involved in obtaining ultrasound access. We used freehand four-dimensional echocardiography in a 79-year-old patient with a trifurcational stenosis. We were able to identify a 6 x 11 mm possibly subintimal atheromathous plaque and to measure the diameters of the left descending coronary artery before, in, and behind the stenosis. There was good agreement with the angiographic measurements. This successful approach may be an argument to motivate further research in this area.