Usefulness of oesophageal irrigation during transoesophageal echocardiographic guidance for structural heart interventions

Q: What are the key findings of this study?

A novel oesophageal irrigation system used during TEE-guided structural heart interventions improved or maintained good image quality and probe manoeuvrability in 97.2% of cases.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Structural heart interventions requiring transoesophageal echocardiography (n=100). Intervention: Oesophageal irrigation system vs. Baseline (pre-irrigation) and historical cohort. Primary outcome: Improvement by ≥1 grade or maintenance of good image quality and probe manoeuvrability after irrigation (p=<0.001).

Q: What question did this study set out to answer?

To evaluate the effectiveness of an oesophageal irrigation system in improving image quality, probe manoeuvrability, and temperature control during transoesophageal echocardiography-guided structural heart interventions, and to assess associated oesophageal lesions.

Julio Iván Farjat-Pasos; Juan Hernando Del Portillo; Laurent D. Biertho; Simon Marceau; Benoît M. Labbé; David Belzile; Kim O’Connor; Jonathan Beaudoin; Mathieu Bernier; Jean‐Michel Paradis; Stéphan Langevin; Erwan Salaün; Josep Rodés‐Cabau

doi:10.1093/ehjci/jeag167

August 14, 2026European Heart Journal - Cardiovascular ImagingOpen Access

Usefulness of oesophageal irrigation during transoesophageal echocardiographic guidance for structural heart interventions

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Key result

Novel esophageal irrigation maintains or improves TEE image quality and manoeuvrability in ~97% of structural cases.

P<0.001
n=100

Figures

Why the study?

Does an oesophageal irrigation system improve image quality and probe manoeuvrability in patients undergoing TEE-guided structural heart interventions?

Key Points

To evaluate the effectiveness of an oesophageal irrigation system in improving image quality, probe manoeuvrability, and temperature control during transoesophageal echocardiography-guided structural heart interventions, and to assess associated oesophageal lesions.
Prospective pilot study of 50 patients (mean age 77.5 ± 6.1 years) undergoing transoesophageal echocardiography-guided structural heart interventions with a dedicated oesophageal irrigation system.
Image quality and probe manoeuvrability were evaluated using a three-item scale before and after irrigation across procedural time periods (0–45, 45–90, and >90 min), alongside probe temperature monitoring.
Pre- and post-procedural esophagogastroduodenoscopy was performed in a subgroup of 22 patients to evaluate gastrointestinal lesions relative to a historical cohort (n = 50).
The primary endpoint was achieved in 97.2% of cases, with image quality improving by ≥1 grade in 28.8% and probe manoeuvrability improving in 29.6% across all procedural intervals (P < 0.001).
Probe temperature decreased significantly after irrigation, demonstrating a mean reduction of 1°C (P < 0.001).
Complex gastrointestinal lesions occurred in 27.3% of irrigated patients compared with 40% in the historical cohort (P = 0.442), with zero incidence of pneumonia or death during hospitalization or at 1 month.

Study Design

Type

Cohort (n=100)

Structured PICO

Does an oesophageal irrigation system improve image quality and probe manoeuvrability in patients undergoing TEE-guided structural heart interventions?

P

Population

100 patients (mean age 77.5 years) undergoing transoesophageal echocardiography-guided structural heart interventions, comprising 50 receiving a novel oesophageal irrigation system and 50 historical controls.

I

Intervention

Novel oesophageal assistance approach (EASI-TEE) incorporating a homemade oesophageal irrigation system consisting of a pediatric orogastric tube attached to the TEE probe.

C

Comparator

Historical cohort of 50 patients who underwent TEE-guided structural heart interventions without the irrigation system (used for comparing the secondary endpoint of GI lesions).

O

Outcome

Improvement by ≥1 grade or maintenance of good image quality and probe manoeuvrability after irrigation, assessed at each irrigation and across three procedural periods (0–45, 45–90, and >90 min).surrogate

Main Result

p-value: p=<0.001

Limitations

Pilot study with preliminary findings on safety and efficacy
Small EGD subgroup limited the analyses, making results hypothesis-generating
Manoeuvrability and image quality were subjectively assessed by a single operator
Small EGD subgroup limited the analyses
Pilot study with preliminary findings considered hypothesis-generating

Implication

A novel oesophageal irrigation system successfully improved TEE image quality and probe manoeuvrability while reducing probe temperature during structural heart interventions, with no increase in complex gastrointestinal lesions.

Abstract

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Discussion

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Cite This Study

Farjat-Pasos et al. (2026) conducted a cohort in Structural heart interventions requiring transoesophageal echocardiography (n=100). Oesophageal irrigation system vs. Baseline (pre-irrigation) and historical cohort was evaluated on Improvement by ≥1 grade or maintenance of good image quality and probe manoeuvrability after irrigation (p=<0.001). A novel oesophageal irrigation system used during TEE-guided structural heart interventions improved or maintained good image quality and probe manoeuvrability in 97.2% of cases.

synapsesocial.com/papers/6ad115a700741cc3fba7d734 https://doi.org/10.1093/ehjci/jeag167

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Usefulness of oesophageal irrigation during transoesophageal echocardiographic guidance for structural heart interventions

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Usefulness of oesophageal irrigation during transoesophageal echocardiographic guidance for structural heart interventions

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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