Simple exposure of the internal thoracic artery for minimally invasive coronary artery bypass.

A simple method is described for harvesting a pedicle of internal thoracic artery for minimally invasive coronary artery bypass grafting with the use of a small scapular retractor. The technique has been used successfully in 39 patients. All patients were followed up early postoperatively by angiography, and the patency rate was 96%. Follow-up angiography (mean [and standard error] 9.6 [4.8] months) was carried out in 63% of the patients, demonstrating a cumulative patency rate of 95.4% with no evidence of steal. None of the patients died and there were no cases of myocardial infarction perioperatively. Recurrent angina developed in 2 patients. This technique is safe, effective and inexpensive.