Restoration of perioperative cellular integrity (REPAIR): "By failing to prepare, you are preparing to fail" (Benjamin Franklin)

In the last decades cardiac surgery with all its subspecialties could achieve a significant improvement in the results for patients through further development of existing methods and the introduction of new techniques. These improvements relate primarily to the surgical techniques but also with respect to the invasiveness, major advances could be achieved through the introduction of numerous minimally invasive methods. Another major potential for patient improvement lies in the direct perioperative course. Groundbreaking research in other fields of life sciences show possibilities for improving the patient's condition through preoperative, intraoperative and postoperative interventions. By positively influencing the immediate postoperative course, a significant reduction of temporary comorbidities appears possible. Also, a transition from the current static risk model, such as the European system for cardiac operative risk evaluation (EuroSCORE) and the Society of Thoracic Surgeons (STS) score, to a more dynamic, "online" recording of the respective risk seems possible. The underlying principle of restoring perioperative cellular integrity (REPAIR) is explained.