Minimally invasive cardiac operations are now possible through different ap
proaches. To provide the best exposure and sufficient space to manipulate t
he heart, a special adapted thoracic retractor has been developed for the m
inisternotomy approach. It is universally adjustable and provides excellent
and consistent exposure especially below the incision edges. The retractor
has the further advantage of a very low profile on the surgeon's side and
at the cephalic and caudal extremes of the operative field, which permits t
he greatest possible access through a limited access. We have successfully
used this retractor in more than 180 patients. A less invasive median stern
otomy through a 6-9-cm incision has been our original approach. (C) 1999 by
The Society of Thoracic Surgeons.