Randomized Feasibility Trial of Routine Versus Selective Transesophageal Echocardiography During Isolated Coronary Artery Bypass Grafting
Authors' conclusion
In this pragmatic randomized feasibility trial, both TEE strategies were successfully implemented with high protocol adherence and preserved clinician and patient equipoise, supporting a multicenter randomized trial evaluating routine vs selective TEE during isolated CABG.
Study context
- Population
- Adults undergoing isolated coronary artery bypass grafting (CABG) for whom both strategies were clinically acceptablerandomized following induction of anesthesia, 274 screened, 72 eligible, 46 (64%) consented
- Participants
- 40 adults
- Comparison
- Transesophageal echocardiography (TEE)-by-default vs TEE-on-demand
- TEE-by-defaultn = 20
- TEE-on-demandn = 20
Methodological details2 tertiary-care hospitals within a single health system
- 2 tertiary-care hospitals within a single health system
Primary result
As reported in the abstract
Primary feasibility outcomes: enrollment, successful randomization, and protocol adherence
- Screened
- 274
- Eligible
- 72
- Consented (of eligible)
- 46 (64%)
- Randomized
- 40 (56% of eligible; 87% of consented)
- Protocol adherence
- 39/40; 98%
- Allocation error
- 1
Further findings
- Clinically triggered TEE in the TEE-on-demand arm
- 15% · 3 of 20 of 20
Safety
Deaths · within 90 days
- No deaths occurred
Serious adverse events adjudicated as related to TEE exposure
- Serious adverse events related to TEE exposure
- Three
- Esophageal complications
- 2
- Conversion to combined CABG and mitral valve replacement
- 1
Original publication
Randomized Feasibility Trial of Routine Versus Selective Transesophageal Echocardiography During Isolated Coronary Artery Bypass Grafting. JACC Adv. Published 20 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it