Anesthesia, surgery and postoperative management Oral lorazepam 0.02 to 0.03 mg/kg will be administered to patients two hours before surgery. General anesthesia will be induced with fentanyl 15 to 20 µg/kg and ketamin. Muscle relaxation will be achieved using pancuronium 0.1 mg/kg. Before cannulation of the heart, heparin (at least 300 U/kg iv) will be administered to each patient. Additional heparin will be administered to achieve and maintain a cephalin kaolin time > 480 sec. CPB will be instituted using a hollow fibre oxygenator (--) and a 40-µm screen arterial filter ( ) with crystalloid priming and a non-pulsatile flow at 32.0 to 34.0°C. Pump prime will be consisted of lactated Ringer’s solution 2000 mL, sodium bicarbonate 8.4% 50 mL and mannitol 20% 3 mL/kg. The pump flow rate will be maintained at 2.4 L/min x m–2 during aortic cross clamping. During CPB, pump flows will be adjusted to maintain mean arterial pressure at 65 to 80 mmHg and hematocrit will be maintained at 20 to 25%. Intermittent use of cardiotomy suction () (0.5–1 L flows) from pericardiotomy to closure of pericardium will be used. A cell saver device will not be used.