Redo left anterior descending artery grafting via left anterior small thoracotomy: An alternative approach

Reoperative left anterior descending artery (LAD) revascularization can be performed through a left anterior small thoracotomy (LAST approach) in pati ents requiring isolated LAD revascularization. If the left internal mammary artery has been previously used, however, the operation is generally perfo rmed either through a median sternotomy or through a full posterolateral th oracotomy for the necessity of connecting the vein graft to the ascending a orta or to the descending thoracic aorta, thus losing the advantages of a m inimally invasive approach. In the case reported herein, we describe a tech nique in which reoperative revascularization of the LAD is accomplished thr ough the LAST approach, using the stump of the left internal mammary artery as the inflow site of a saphenous vein coronary graft to the LAD. (Ann Tho rac Surg 2001;71:384-5) (C) 2001 by The Society of Thoracic Surgeons.