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.