Fast track in cardiac surgery is not well defined. In the past early or immediate extubation was used as a marker. After cardiac surgery this parameter is not sufficient. In addition to cardiorespiratory stability, circulatory and haemostatic homeostasis are also required. Therefore the current Fast Track concept includes a period of intensive monitoring of the patient postoperatively to establish stability. Thereafter intensive care medicine should not be required. Evolving new surgical concepts in combination with appropriate anaesthesiologic management will lead to wide application of fast track cardiac surgery in the future.