Surgery Anaesthesia was standardized and maintained with propofol, sufentanil and vecuronium. Surgery was always performed through median sternotomy. LIMA was harvested as a pedicle, anastomosed to the left anterior descending artery in all cases, and never used as a free graft. CPB circuit included a Sorin phosphorylcholine-coated tubing set (Sorin Group SpA, Milano, Italy), a Jostra roller pump (Jostra, Maquet Cardiopulmonary, Hirrlingen, Germany), and a hollow fiber membrane coated oxygenator, which incorporated also a 40 μm filter (Sorin Synthesis™, Sorin Group Spa, Milano, Italy). Heparin was given at a dose of 300 IU/kg to achieve a target activated clotting time of 480 s or above. The extracorporeal circuit was primed with 1400 mL of Ringer's lactate solution and 5000 IU of heparin. A non-pulsatile CPB flow was established at 2.4 L/min. Buckberg crystalloid cardioplegic solution was used to maintain cardioplegia during aortic cross-clamping. Infusion of 4 mg/kg of protamine was used to neutralize heparin after finishing the CPB. Residual blood was sucked from the venous reservoir into the cell saver collection reservoir using a dual lumen tube connected to a vacuum pump and subsequently transferred to the 125-ml centrifuge bowl of the cell saver (Cell Saver 5; Haemonetics, Braintree, MA, USA). Cells were washed using 2000 ml bags NaCl 0.9% with 30.000 IU of heparin (Athena Pharma, Rome, Italy). The following cell saver program was used for the cell saver: 5600 r.p.m., filling and washing rate of 250 ml/min, emptying rate 250 ml/min, wash volume 1000 ml. Concentrated blood cells were drained into a patient labelled soft collection bag.