 This double-blinded trial will randomize according to a power analysis 1250 cardiac surgery patients 625625 at Meilahti hospital to use either 4 Albumin or Ringers acetate solutions for both priming of the heart-lung machine and perioperative volume replacement therapy. The primary efficacy and safety endpoint of this study is the incidence of major adverse events MAE, defined as a composite endpoint of all-cause mortality, acute myocardial infarction, acute heart failure or low output syndrome, resternotomy, stroke, certain arrhythmias, major bleeding, infections compromising post-procedural rehabilitation, acute kidney injury within 90 days postoperatively. The secondary outcomes are total number of MAEs, major adverse cardiac events MACE, perioperative fluid balance, blood product transfusions, blood loss, acute kidney injury, days alive without mechanical ventilationoutside ICUat home in 90 days as well as 90-day mortality. Blood samples for biochemical analyses will be collected at four perioperative time points. 