Obese patients undergoing cardiac surgery have been shown to have a high risk of developing postoperative complications, specifically: increased length of hospital stay, readmission to intensive care unit, acute renal failure, deep sternal wound infections and new onset of atrial fibrillation.A custom-made circuit was created to allow the use of Mini Extra Corporeal Circulation (MECC) but permitting the switch to a closed siphon drainage system in the case of difficulties.To limit artificial surface contact a small oxygenating device (Admiral, Eurosets) was employed in spite of the patients size. This adapted circuit permits a feasible and safer approach to using MECC. This report suggests that smaller oxygenators could be integrated into clinical practice in an adult MECC configuration, even for more obese patients, limiting artificial surface contact.