Abstract
A 68-year-old female had chest pain on exertion and went to hospital. Coronary angiogram showed triple vessel disease with 50% stenosis of the left main trunk (LMT). Coronary artery bypass grafting (CABG) for complete revascularization was scheduled. Saphenous vein graft (SVG) was planned to use for the circumflex artery, because the stenosis of LMT was not severe. Minimally invasive cardiac surgery CABG (MICS CABG) was performed via a small left thoracotomy on the 4th intercostal space. After two SVGs were anastomosed to the ascending aorta with a side clamp via the incision, the left internal thoracic artery (LITA) was grafted to the left anterior descending artery (LAD). Each SVG was anastomosed to the posterior descending artery (PDA) and the high-lateral artery (HL) with a heart positioner and an epicardial stabilizer. All anastomoses were made under direct vision without the use of cardiopulmonary bypass (CPB) or blood transfusion. All the graft patency was postoperatively confirmed by a computed tomography coronary angiography. MICS CABG avoiding median sternotomy without the use of CPB can be a good alternative procedure to standard CABG.
