Randomized Feasibility Trial of Routine Versus Selective Transesophageal Echocardiography During Isolated Coronary Artery Bypass Grafting.
Routine vs selective transesophageal echocardiography strategies during coronary artery bypass grafting were feasible with high protocol adherence
Randomized Feasibility Trial of Routine Versus Selective Transesophageal Echocardiography During Isolated Coronary Artery Bypass Grafting.
Intraoperative transesophageal echocardiography (transesophageal echocardiography) is used in approximately half of isolated coronary artery bypass grafting (coronary artery bypass grafting) procedures in the United States, yet its routine use remains unsupported by randomized evidence.
The objective of the study was to assess the feasibility and protocol adherence of routine vs selective intraoperative transesophageal echocardiography strategies during isolated coronary artery bypass grafting surgery.
We conducted a pragmatic, randomized feasibility trial at 2 tertiary-care hospitals within a single health system.
In the transesophageal echocardiography-on-demand arm, 3 of 20 patients (15%) underwent clinically triggered transesophageal echocardiography.
No deaths occurred within 90 days.
Three serious adverse events were adjudicated as related to transesophageal echocardiography exposure including 2 esophageal complications and 1 conversion to combined coronary artery bypass grafting and mitral valve replacement.
In this pragmatic randomized feasibility trial, both transesophageal echocardiography strategies were successfully implemented with high protocol adherence and preserved clinician and patient equipoise, supporting a multicenter randomized trial evaluating routine vs selective transesophageal echocardiography during isolated coronary artery bypass grafting.