title: Coronary revascularization without cardiopulmonary bypass in patients with pectus excavatum.
abstract: BACKGROUND
  Coronary revascularization in patients with pectus excavatum is technically difficult through a median sternotomy secondary to the posterior displacement of the sternum and the asymmetric angulation that it produces. 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 revascularization of the left anterior descending artery without cardiopulmonary bypass through a left anterior minithoracotomy.
  
  
  RESULTS
  All patients underwent the procedure without intraoperative complications 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 sternotomy and cardiopulmonary bypass. This procedure is deemed safe and effective in patients with such deformities of the chest wall.
authors.affiliation: Department of Surgery, Medical College of Georgia, Augusta 30912-4000, USA. pkim@mail.mcg.edu
authors.forename: P Y
authors.initials: PY
authors.lastname: Kim
authors.forename: T
authors.initials: T
authors.lastname: Wittwer
authors.forename: A
authors.initials: A
authors.lastname: Haverich
authors.forename: J T
authors.initials: JT
authors.lastname: Cremer
mesh_terms: D002315:Cardiopulmonary Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005660:Funnel Chest / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009204:Myocardial Revascularization; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed