RecruitingNCT07390903

GLS in Difficult CPB Weaning

Global Longitudinal Strain as a Predictor of Difficult Separating From Cardiopulmonary Bypass

Sponsor

Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital

Enrollment

213 participants

Start Date

Feb 5, 2026

Study Type

OBSERVATIONAL

Conditions

Heart Valve Diseases Coronary Artery Bypass Echocardiography Cardiopulmonary Bypass Postoperative Complications (Cardiopulmonary)Intraoperative Complications

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

Min Age: 18 Years

Inclusion Criteria10

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 Criteria8

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.

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Interventions

DIAGNOSTIC_TESTMyocardial strain imaging

Two-dimensional strain analysis was performed using frame-by-frame tracking of unique patterns of bright and dark pixels in grayscale (B-mode) sector images to assess myocardial deformation. The frame rate was maintained between 40 and 90 Hz. The myocardium in each image was divided into six myocardial segments, which were individually assessed for tracking quality. GLS was calculated as the average strain value of 18 myocardial segments obtained from the three echocardiographic views. Patients were included in the final analysis if at least 15 out of 18 segments were considered acceptable for strain measurement by the investigator.