Among the 64 patients screened for eligibility, 24 were excluded: 8 of these patients had arteriovenous fistulas for hemodialysis in their arms, 2 had poorly controlled diabetes requiring insulin injection, 1 had peripheral vascular obstructive disease, 3 had histories of cerebrovascular events within 6 months, preoperative LV EF was < 35% in 5 patients, co-operations for other organs were planned in 2 patients, minimally invasive procedures were planned in 2 patients, and 1 was a redo surgery. Here, INS is linked to diabetes mellitus.