The concept of mini cardiopulmonary bypass (mini-CPB) has been introduced in clinical practice from early 2000 for advancing perfusion technology aiming to improve cardiac surgical results. The diversity of custom-made circuits and the poor methodological quality of many trials published during the first decade of their clinical application led to the establishment of Minimal Invasive Extracorporeal Technologies International Society (MiECTiS). Thus, creating a common language between cardiac surgeons, anesthesiologists and perfusionists, and paving the way for the development of physiological minimally invasive perfusion towards advancing patient care.² MiECTiS introduced the criteria for minimal invasive extracorporeal circulation (MiECC) that is designed to offer the maximum clinical benefit and created a solid ground for producing credible results by comparing MiECC and conventional cardiopulmonary bypass circuits (cCPB).³ The results over the years induced many perfusionists to modify their clinical practice and adopt advanced perfusion technology. Hence, contemporarily, the “standard” CPB circuit is literally considered a misnomer superseded by “optimized” extracorporeal circulation (opECC).⁴