Complete direct mammary harvest for minimally invasive coronary artery bypass.

Minimally invasive coronary artery bypass has primarily involved left internal mammary artery grafting to the left anterior descending coronary artery through a small left anterior thoracotomy incision. Harvesting of the mammary artery has been accomplished completely using a video-assisted thoracoscopic technique or incompletely to the second interspace under direct vision. With a mammary retractor, the mammary artery can be dissected completely under direct vision, thus eliminating any criticism of an incomplete harvest and any increased difficulty or expense associated with the thoracoscopic harvest. In this series, all 17 mammary arteries were successfully harvested completely under direct vision and 16 patients underwent successful minimally invasive coronary bypass.