Assement of Left Ventricular Function Before Decannulation in Cardiac Surgery :Visual Estimation vs TEE

Inclusion Criteria: * Age between 18 and 75 years * Scheduled for elective cardiac surgery requiring cardiopulmonary bypass (CABG, valve surgery, or aortic surgery) * ASA physical status III-IV * Able and willing to provide written informed consent * Suitable for intraoperative transesophageal echocardiography (TEE) Exclusion Criteria: * Emergency surgery * Known severe preoperative left ventricular dysfunction (EF \< 30%) * Significant arrhythmias (e.g., atrial fibrillation) * Preoperative requirement for mechanical circulatory support (e.g., IABP) * Contraindications to TEE (esophageal pathology, bleeding risk, strictures) * Inability to provide informed consent