Minimally invasive internal thoracic artery harvest: The hybrid approach

Background. Safe harvesting of the left internal thoracic artery is a diffi cult problem during minimally invasive coronary artery bypass grafting with out cardiopulmonary bypass. A complete internal thoracic artery dissection through a limited approach is technically demanding and time consuming and different techniques have been proposed. Methods and Results. Based on our experience, the different surgical approa ches and technical considerations are reviewed. Conclusions. A hybrid technique using dissection under direct vision and co mpleted by thoracoscopy is discussed and proposed as our preferred techniqu e of internal thoracic artery harvesting. (Ann Thorac Surg 1999;67:632-4) ( C) 1999 by The Society of Thoracic Surgeons.