Inclusion Criteria:  Are to undergo non-emergent cardiac surgery >18 years of age Willing and able to provide informed consent  Exclusion Criteria:  History of endocarditis Dialysis-dependent renal failure Currently on pre-operative mechanical circulatory support (i.e. ECMO, LVAD or intra-aortic balloon pump [IABP]) Contraindication to receiving a blood transfusion (i.e. Jehovah's Witness) Emergency procedures