The first 90 cardiac surgery cases perfused with a new hollow fiber membrane oxygenator in which the gas flows through the fibers and blood flows around the fibers are reported. The fibers are microporous polypropylene with a pore size of 0.03 microns. Membrane surface area is 2.0 M2 and priming volume is 480 ml, including heat exchanger PaO2 is controlled by FIO2 and PaCO2 by gas flow rate. Patients as large as 2.36 M2 were perfused up to 348 min using hemodilution and hypothermia. The mean PaO2 was 200 mmHg and the mean PaCO2 39.5 mmHg. Oxygen transfer was as high as 230 ml/min. This low prime device transfers large volumes of gas, an efficiency which results from a crossed arrangement of the fibers to break up laminar flow of the blood around them. The low priming volume makes it appropriate for use in all but the smallest patients.