['The detrimental effects of inflammation following cardiopulmonary bypass (CPB) could negatively affect the postoperative outcome in a specific subset of high-risk patients. We therefore investigated the impact of a CPB circuit (Admiral, Eurosets, Italy) that allows separation of intracavitary and mediastinal blood on the release of biochemical markers and clinical outcome when compared with a conventional circuit.', 'Thirty patients undergoing aortic valve surgery were prospectively enrolled and assigned to Admiral group (Group 1, G1, n\u200a=\u200a15) or conventional CPB group (Group 2, G2, n\u200a=\u200a15). The Admiral oxygenator allows for a separate collection of mediastinal blood processed through a cell-saver before retransfusion. Clinical data and biochemical parameters were measured preoperatively, during CPB and at different time-points postoperatively.', 'Preoperative demographics, intraoperative data (as CPB and aortic cross-clamping time) and perioperative complications did not differ between groups. Inflammatory response was significantly decreased in G1, as assessed by means of D-dimer (G1\u200a=\u200a1332.3 \u200a± \u200a953.9 vs. G2\u200a=\u200a2791.9 \u200a± \u200a1740.7\u200a ng/ml, P\u200a=\u200a0.02), C-reactive protein (G1\u200a=\u200a169.1\u200a ±\u200a 164.8 vs. G2\u200a=\u200a57.1 \u200a± \u200a39.3\u200a mg/l, P\u200a=\u200a0.04), interleukin-6 (G1\u200a=\u200a11.8 \u200a± 12.5 vs. G2\u200a=\u200a26.5 \u200a±\u200a 24.9 \u200apg/ml, P\u200a=\u200a0.02) and tumour necrosis factor-alpha (G1\u200a=\u200a29 \u200a±\u200a 28.7 vs. G2\u200a=\u200a45.5 \u200a±\u200a 23.6\u200apg/ml, P\u200a=\u200a0.03).'] Does separation of mediastinal shed blood during aortic valve surgery elicit a reduced inflammatory response?