Cardiac surgery has undergone major changes in the recent past. With changes came new knowledge, technology and progress, all aimed at providing better care to our patients. Fundamentally, however, cardiac surgery "is myocardial protection," the realization that no matter how perfect the reparative surgery, myocardial function has to be preserved for a short and long-term successful outcome. The pace of technological advancements has accelerated over the last five years, allowing surgeons to perform cardiac surgery differently and more comfortably. For each procedure, there is the need for different technology, such as devices, valves, suture materials, stabilizers, shunts, blowers, and others. One factor, however, has remained constant, i.e. the need for individualization for a specific method of myocardial protection tailored to each operation.