High frequency (7.5 MHz) two-dimensional ultrasound in combination with modified acoustic windows allowed visualization of the distal left anterior descending artery in 61 (85%) of 72 patients studied. Visualization was confirmed in one patient who underwent simultaneous high frequency ultrasound recording and selective dye injection into the left coronary artery. In addition, calcific coronary atherosclerosis was identified in one patient. The saphenous vein bypass graft along with its distal site of anastomosis was clearly seen in 3 patients and coronary artery flow was detected in 24 (33%).