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.