ARTERIAL MYOCARDIAL REVASCULARIZATION WITHOUT CARDIOPULMONARY BYPASS THROUGH A SMALL THORACOTOMY

The opportunity to obviate the risks associated with cardiopulmonary b ypass (CPB) while maintaining the long-term survival previously demons trated with the use of arterial grafts, led us to perform myocardial a rterial revascularization without CPB, using a small left thoracotomy as the surgical approach. One patient was operated on with this techni que grafting the left anterior descending artery with the left interna l mammary artery and grafting sequentially the first diagonal branch a nd the first marginal branch with a T-graft of radial artery. A small anterolateral thoracotomy was performed and the proximal harvesting of the left internal mammary artery was video-assisted by thoracoscopy. No hemodynamic deterioration occurred during the procedure. The patien t was discharged on postoperative day 5 and the postoperative course w as uneventful.