Outcome Impact of Different Tranexamic Acid Regimens in Cardiac Surgery with Cardiopulmonary Bypass (OPTIMAL): Rationale, Design, and Study Protocol of a Multicenter Randomized Controlled Trial

MiECC use translates to improved end-organ protection and clinical outcome, as evidenced in multiple clinical trials and meta-analyses. MICS performed with MiECC provides the basis for developing a multidisciplinary intraoperative strategy towards a “more physiologic” cardiac surgery by combining small surgical trauma with minimum body’s physiology derangement. Integration of MiECC can advance MICS from non-full sternotomy for selected patients to a “more physiologic” surgery, which represents the real face of modern cardiac surgery in the transcatheter era.