Please select the eligibility criteria that correspond to the clinical trial below.
Title: Prospective Randomized Comparison of Coronary Bypass Grafting With Minimal Extracorporeal Circulation System (MECC) Versus Off-pump Coronary Surgery. New Insights Into Inflammatory Cytokines.
Brief Summary: The investigators aimed to evaluate the clinical results and the inflammatory response of the minimal extracorporeal circulation system (MECC) Compared with off-pump coronary revascularization (OPCABG).

This is a randomized and prospective study in 230 patients with indications for coronary surgery, with 113 patients in the OPCABG group and 117 in the MECC group. The endpoints were the clinical and biochemical results, intra-operative outcomes and the determination of 19 inflammatory circulating markers, 17 of them for the first time analyzed comparing both techniques.


Options:
A: Inclusion Criteria:

* Elective complex cardiac surgery (combined valve and coronary bypass grafting surgery, concomitant valve surgery, surgery of the ascending aorta and aortic arch, as well as re-operations of the same type)
* Age \> 18 years

Exclusion Criteria:

* Disagreement to participate in the study
* Age \< 18 years
* Pregnancy
* Emergency procedure
* Heart transplantation
* Implantation of LVAD (left ventricular assist device), RVAD (right ventricular assist device) or TAH (total artificial heart)
* Treatment with chemotherapy, immunosuppressive therapy
* Treatment with anti-leukocyte drugs or TNF-alfa blockers
* Immunocompromised patients (AIDS), leucopenia (\< 4,0x109 / L)
* Clinical and/or laboratory signs of infection (CRP \>2 mg/dl)
* Serum creatinine \>2 mg/dl
* Bilirubin \>2 mg/dl
* History of stroke
* Malnourished patients, BMI \< 18
B: Inclusion Criteria:

* Indication for coronary surgery established on the basis of current published guidelines

Exclusion Criteria:

* Documented preoperative systemic proinflammatory status and/or steroid administration within 6 months before surgery.
* Coexistence of a cardiomyopathy different than coronary artery disease that precise surgical treatment.
* Left ventricle ejection fraction of 40% or less.
* Treatment with erythropoietin (EPO) three months before the intervention
* Hematocrit less than 35% the day prior to the procedure
* Redo surgery
C: Inclusion Criteria:

1. Age greater than 18 years
2. Require CPB for any cardiac surgical procedure (such as CABG, Valve, Aorta, or combined procedures)
3. Must have a EuroSCORE ≥ 6
4. Provide written informed consent

NOTE: For participating sites in India, China and Hong Kong, the following eligibility criteria will be applied:

1. Age greater than 18 years
2. Require CPB for any cardiac surgical procedure (such as CABG, Valve, Aorta, or combined procedures)
3. Must have at least one of the following:

   1. EuroSCORE greater than or equal to 4 and undergoing valvular surgery
   2. EuroSCORE greater than or equal to 6 and undergoing any other cardiac surgery procedure (i.e. CABG, Aorta)
4. Provide written informed consent

Exclusion Criteria:

1. Use of systemic corticosteroids
2. History of bacterial or fungal infection in last 30 days
3. Allergy/intolerance to corticosteroids
4. Will receive Aprotinin
5. Previous participation in study
D: Inclusion Criteria:

* Patients undergoing elective isolated coronary artery bypass surgery with on-pump technique
* Written informed consent

Exclusion Criteria:

* Concomitant valve or aortic surgery
* Left ventricular aneurysm repair
* Re-operation
* Emergency surgery
* History of myocardial infarction within less than 4 weeks
* Hepatic impairment
* Chronic renal impairment
* Drug related side effects (allergy or hypersensitivity)
* Familial Hyperlipidemia
* Autoimmune conditions which require steroids

Answer: B