Minimally invasive extracorporeal technologies (MiECT) are in great expansion in the literature and have an impact in adult cardiac surgery, however, a future challenge will be to expand MiECT to pediatric cardiac surgery. In the context of pediatric MiECT, there are not enough studies in the literature on this topic, which seems a paradox because the optimizations in cardiopulmonary bypass (CPB) are the essence on literature and practice in the pediatric approach during cardiac surgery. In pediatric cardiac surgery, body weight-adjusted miniaturized CPB circuits within a comprehensive blood-sparing approach can reduce transfusion requirements. Haemodilution resulting from mixing the patient’s blood with a CPB crystalloid solution may be reduced to the extent that asanguineous priming becomes possible[1]. Therefore, we adopted asanguineous priming in our clinical routine[2]. However, optimizations in the traditional circuit, if on the one hand reduce the consumption of blood products, on the other, require the use of vacuumassisted venous drainage (VAVD). VAVD is essential to reduce the length of the circuit, to place the oxygenating system and the venous reservoir at the child patient’s height and to optimize venous return.