1. 執行正中胸骨切開術 (Median sternotomy)

2. Heparinization (Heparin: 400u /kg)

3. Distal Ascending Aortic Cannulation

4. Bicaval / RA venous cannulation

5. Pump on

6. Cannulation of cardiologic perfusion site over proximal ascending aorta

7. Aortic cross-clamp

8. Block CPB 的artery flow 及cardioplegia flow

9. Initiate cardiac ischemia

10. Venting (引流)of LA/PV( L’f side)

11. Cardioplegic perfusion for cardiac protection

12. Cooling & operation