Coronary revascularization without cardiopulmonary bypass in patients withpectus excavatum

Background. Coronary revascularization in patients with pectus excavatum is technically difficult through a median sternotomy secondary to the posteri or displacement of the sternum and the asymmetric angulation that it produc es. The role of minimally invasive coronary artery bypass grafting (MIDCABG ) in this subset of patients was evaluated. Methods. In 1998, four patients with pectus excavatum underwent revasculari zation of the left anterior descending artery without cardiopulmonary bypas s through a left anterior minithoracotomy. Results. All patients underwent the procedure without intraoperative compli cations and postoperative angiography demonstrated adequate graft patency. Conclusions. The advantages of MIDCABG in patients with pectus excavatum is the superior exposure to the LAD and LIMA and avoidance of a median sterno tomy and cardiopulmonary bypass. This procedure is deemed safe and effectiv e in patients with such deformities of the chest wall. (C) 1999 by The Soci ety of Thoracic Surgeons.