Eligibility criteria:  elective adult cardiac surgery (Coronary revascularization surgery, Mitral valve surgery, Aortic valve surgery or complex surgery (either two or more valves or valves and coronary revascularization surgery). All surgery should be with CPB. All patients will be diagnosed with preoperative PH. PH was defined as a mean pulmonary artery pressure (MPAP) 30 mmHg or a systolic pulmonary artery pressure (SPAP) 40 mmHg, measured during preoperative right-sided catheterization or estimated by using doppler transthoracic echocardiography.  Exclusion Criteria:  Cardiac surgery without CPB. Hemodynamic instability in the preoperative time (defined as acute requirement for vasoactive support or mechanical device). Adult congenital heart disease planned for corrective surgery. Contraindication to transesophageal echocardiography (TEE). Any surgery involves tricuspid valve annulus as it will compromise the accuracy of RV function assessment by TEE.