We read with great interest the manuscript by Stygall J et al. comparing intermittent crossclamp fibrillation and cardioplegic arrest during coronary artery bypass grafting on microemboli and neuropsychology. We believe the manuscript requires certain points to be stressed on. Additionally, we would like to comment on the issue about the use of fibrillation technique with our modification. Coronary artery bypass grafting is one of the most commonly performed cardiovascular surgery daily practice procedures. Among the patients, only about 10-20% requires additional special care and alternative protective measures; otherwise, surgery is routinely performed on-pump, off-pump, intermittant cross-clamp fibrillation ... etc. There is not a widely accepted concensus about the best technique for the high risk patients and the real difference between myocardial protection techniques would come true when tested among high risk patients.
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