From minimal invasive extracorporeal circulation type I to type III: the perfusionist’s view

The main challenge of modern cardiac perfusion technologies is the achievement of optimal biocompatibility for extracorporeal circulation (ECC) circuits. The unfavorable pathophysiological side effects of conventional cardiopulmonary bypass (CPB) circuits on the organ systems are triggered by complement system activation through foreign surfaces, hemodilution due to the priming volume, blood-air contact as well as negative and positive pressures in the reservoir (1,2).