HemoSphere Alta Study

Inclusion criteria

• Signed informed consent
• Age ≥ 18 years
• Planned monitoring with a pulmonary artery catheter
• Patient scheduled to undergo cardiac or liver transplant surgery lasting > 2 hours
• Additional criteria for Sub-Cohort A (RVF)

• Possible Right Ventricular Dysfunction/Failure based on pre-operative assessment of previous Transthoracic Echocardiogram (TTE)
• Planned Transesophageal Echocardiogram (TEE) assessment during the operative procedure
• Additional criteria for Sub-Cohort B (CAI)

• Age ≥ 45 years
• Planned cardiac surgery with Cardiopulmonary Bypass (CPB)
• Ability to place ForeSight IQ and Acumen IQ sensors during the operative monitoring period
• High risk for cerebral vascular disease, defined as: a history of hypertension, pulse pressure > 60 mmHg, diabetes, stroke, transient ischemic attack, carotid bruit, tobacco smoking, or peripheral vascular disease

Exclusion criteria

• Inability to provide informed consent
• Pregnancy as confirmed per EMR
• Patients deemed not suitable for the study at the discretion of the Investigator
• Participation in another study that clinically interferes with the current study
• Additional exclusion criteria for Sub-Cohort A

• Presence of left bundle branch block
• Presence of current/recurrent sepsis
• Presence of hypercoagulability, as identified in the patient's past medical history and preoperative evaluation
• Structural abnormality, including congenital heart defects, of the right ventricle
• Additional exclusion criteria for Sub-Cohort B a. Surgery for congenital heart defect