title: Instrumentation for minimally invasive internal thoracic artery harvest.
abstract: The anterior fourth interspace minithoracotomy is our current choice for exposure of the anterior myocardial wall for minimally invasive coronary bypass grafting procedures. This approach provides direct access to the left anterior descending coronary artery for anastomosis, and good exposure of the midsegment of the internal thoracic artery. We describe the use of instrumentation that facilitates the harvest of the left internal thoracic artery under direct vision. The use of this retractor system, which elevates the third and fourth and depresses the second and first ribs, permits better visualization of the internal thoracic artery and allows for proximal internal thoracic artery harvest without rib resection.
authors.affiliation: Department of Surgery, University of Louisville, Kentucky 40202, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Qaqish
authors.forename: S
authors.initials: S
authors.lastname: Pagni
authors.forename: P A
authors.initials: PA
authors.lastname: Spence
mesh_terms: D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000295:instrumentation* / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D013895:Thoracic Arteries / Q000601:surgery*; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods