Perioperative red blood cell (RBC) transfusion is the single

factor most consistently associated with an increased risk of

postoperative morbid events after isolated coronary artery

bypass grafting (CABG), and each unit of RBC transfused

is associated with incrementally increased risk for adverse

ECC) has been proposed to limit perioperative blood product

use. Mini-ECC consists of a closed ECC system with

no cardiotomy suction or venous reservoir. The rationale is

to avoid air–blood contact and minimize priming volume,

thus reducing hemostasis alteration and intraoperative hemodilution.

However, there is still controversy on whether

such a strategy effectively reduces postoperative RBC transfusion,

with some reports showing no evident benefit.

We conducted a meta-analysis on available randomized

controlled trials (RCTs) to evaluate whether mini-ECC decreases

the risk of postoperative RBC transfusion compared

with conventional ECC in patients undergoing CABG.