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In the 50 years since the advent of cardiopulmonary bypass (CPB) the extracorporealcircuit (ECC) and its application has undergone variable evolutionary change.Arguably the most consistent focus for developmental change has been the oxygenator.Other aspects of the ECC still in routine use (such as roller pumps) have undergone comparatively little change and only recently has there been a focus on reducing the size of the CPB circuit.