title: Minimally invasive coronary artery bypass grafting.
abstract: BACKGROUND
  Standard options for the invasive management of proximal disease of the left anterior descending coronary artery include coronary artery bypass grafting with a left internal mammary artery and percutaneous transluminal coronary angioplasty.
  
  
  METHODS
  We describe a surgical technique for bypass of the left anterior descending coronary artery with a left internal mammary artery without median sternotomy and without cardiopulmonary bypass. Thoracoscopy is used to harvest the internal mammary artery, whereas the mammary-coronary artery anastomosis is performed under direct vision through a limited anterior thoracotomy.
  
  
  RESULTS
  We have performed this procedure successfully in 3 patients with minimal morbidity and shortened hospital stay. Average operative time was 3 hours and postoperative hospital stay averaged less than 48 hours.
  
  
  CONCLUSIONS
  Although experience is limited and follow-up is very short, with further experience, this less invasive surgical technique may become a viable option for the management of proximal left anterior descending disease.
authors.affiliation: Division of Cardiothoracic Surgery, Medical City Dallas Hospital, Texas, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Acuff
authors.forename: R J
authors.initials: RJ
authors.lastname: Landreneau
authors.forename: B P
authors.initials: BP
authors.lastname: Griffith
authors.forename: M J
authors.initials: MJ
authors.lastname: Mack
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D004724:Endoscopy; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D013906:Thoracoscopy; D014654:Vascular Patency