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Transesophageal Echocardiographic Monitoring for Selective Antegrade Cardioplegia: A Prospective Self-Controlled Before-After Study

Basic Information

Recruitment status	Recruiting
Health condition(s) or Problem(s) studied	Cardiovascular surgery using cardiopulmonary bypass
Date of first enrollment	17/02/2026
Target sample size	53
Countries of recruitment
Study type	Interventional
Intervention(s)	Monitoring of Selective Coronary Perfusion Using Transesophageal Echocardiography

Outcome(s)

Primary Outcome

The frequency of perfusion failure during selective coronary perfusion, and the frequency of perfusion failure following monitoring by transesophageal echocardiography (improvement rate). If the improvement rate achieved through monitoring was not 100% (since statistical verification is unnecessary if improvement is possible with 100% probability), the exact McNemar test is used to verify whether the improvement in perfusion insufficiency through monitoring is statistically significant.

Secondary Outcome

Cardioplegic circuit pressure and flow rate during infusion of cardiolegic solution Record values for left coronary artery only, simultaneous left and right (adding right coronary artery), when perfusion failure occurs, and when perfusion failure improves. Test for significant differences in circuit pressure and flow rate based on the presence or absence of perfusion failure. If normality is present, perform an independent t-test; if normality is absent, perform a Mann-Whitney U test and calculate the 95% confidence interval. When perfusion failure is resolved, record the cause of the failure if identified (e.g., catheter kinking, misidentification of the inlet, calcification at the coronary artery inlet or proximal segment).

Key inclusion & exclusion criteria

Age minimum	>= 18age old
Age maximum	Not applicable
Gender
Include criteria	1. Patients scheduled to undergo cardiac surgery using cardiopulmonary bypass 2. Patients scheduled to undergo selective antegrade cardioplegia 3. Patients aged 18 years or older at the time of consent acquisition 4. Patients for whom written consent has been obtained for participation in this study
Exclude criteria	1. Patients with contraindications for transesophageal echocardiography as listed below Esophageal stricture, esophageal varices (red color sign [RC] grade 1 or higher), esophageal diverticulum, post-gastric/esophageal surgery, esophageal cancer, bleeding/ulcers/tumors in the stomach or esophagus, history of neck/mediastinal radiation therapy, cervical spine injury, or other conditions requiring restricted neck mobility 2. Patients deemed unsuitable for the procedure by the attending physician