Inflammatory effects of extracorporeal circulation

We congratulate Freundt et al. for the successful results of the minimised extracorporeal circulation (MECC) used in elderly patients who underwent coronary bypass surgery.1 This study reveals significant differences, especially in extracorporeal circulation time, cross-clamp time and reperfusion time, when MECC and conventional extracorporeal circulation are compared. It is also stated that these parameters are determined especially on 30-day mortality. The systemic inflammatory response syndrome (SIRS), which is seen with extracorporeal circulation, is one of the most important parameters that influences postoperative results in coronary bypass surgery.2–4 On this point, extracorporeal circulation should be handled separately because, as Wan et al. mentioned in their study, extracorporeal circulation triggers the systemic inflammatory response regardless of myocardial ischemia and aortic cross-clamp time.3 In this context, in light of the study of Freundt et al., can we claim that the lesser systemic inflammatory response is the reason for the better results of MECC compared to the conventional procedure? We think that opinions from the authors will add value to their study.