Surgical Technique
All patients were evaluated preoperatively for peripheral vascular
status by aorto-iliac and femoral artery ultrasonography. The patient
was placed in a 30° left side position, double-lumen endotracheal tubes
were placed in all patients. Arterial pressure monitoring was performed
via the left radial artery, and the floating catheter was placed through
the right internal jugular vein. Femoral arterial and vein cannulations
were directly performed using the Seldinger technique with two 5/0
Prolene purse strings through a groin incision (2.5cm). Cardiopulmonary
bypass (CPB) was routinely established through the femoral artery,
femoral vein, and right internal jugular vein. The main surgical hole
(approximately 4.5cm) was established in the third intercostal, through
which the cardiac arrest fluid flushing tube was also passed. The
thoracoscopy was placed through anterior axillary line of the second
intercostal space, after inserting the aortic root cannula, while the
left cardiac drainage and Chitwood clamp were punctured through the
fourth intercostal space, and an artificial pneumothorax is routinely
established using CO2.