GLS in Difficult CPB Weaning

Summary

The goal of this observational study is to learn whether global longitudinal strain (GLS), measured by echocardiography, can predict difficulty separating from cardiopulmonary bypass (CPB) in adults undergoing elective cardiac surgery. The main questions it aims to answer are: * Can preoperative GLS measurement predict difficult separation from CPB? * Are GLS values associated with outcomes such as intensive care unit (ICU) stay, hospital stay, cardiac biomarkers, or 30-day mortality? Participants will: * Undergo standard cardiac surgery requiring CPB * Have echocardiographic assessments (TTE before and after surgery) * Have their recovery and outcomes monitored, including ICU and hospital stay, postoperative labs, and survival within 30 days

Eligibility

Inclusion Criteria

* Age \> 18 years.
* Scheduled for elective cardiac surgery requiring cardiopulmonary bypass (CPB).
* Provided written informed consent to participate.
* Eligible surgical procedures include:

  * Isolated mitral valve replacement or repair.
  * Isolated aortic valve replacement or repair.
  * Isolated coronary artery bypass grafting (CABG).
  * Combined valve and CABG surgery.
  * Multiple valve replacement or repair.
  * Surgery involving the ascending aorta or aortic arch.

Exclusion Criteria

* Emergency cardiac surgery.
* Redo cardiac surgery.
* Contraindications to transesophageal echocardiography (TEE).
* Critical preoperative conditions, including:

  * Ongoing inotropic drug therapy.
  * Preoperative mechanical circulatory support (e.g., IABP, ECMO, VAD).
  * Requirement for mechanical ventilation.
  * Preoperative atrial fibrillation.

Conditions7

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