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      <image:caption>Highlights from Paper Guideline recommendations for transesophageal echocardiography (TEE) in isolated coronary artery bypass graft (CABG) surgery are equivocal. Intraoperative TEE use during isolated CABG is highly variable across the United States. This study leveraged the highly variable practice pattern differences in TEE use during isolated CABG to approximate the design of a cluster-randomized trial within the framework of an observational study by using a matched-pair, instrumental variable design.</image:caption>
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