“…3 In some centers, a minimally invasive approach has become the standard for mitral valve surgery. 6,7 Notably, in addition to the risks, femoral perfusion may be rendered more difficult with the use of the intraluminal aortic occlusion balloon catheter because it occupies a significant part of the femoral cannula lumen (9F catheter in a 21F or 23F cannula). Femoral arterial cannulation, in particular, is not without risk, with potential complications including groin wound infection, wound seroma, intraoperative arterial injury requiring reconstruction, aortic dissection, atheroembolism, and limb ischemia.…”