The "T-shaped" thoracotomy for pericardiectomy after midline crossed IMA grafting.

In the presence of an internal mammary artery graft crossing the mid-sternal line, a median sternotomy may jeopardize the graft and consequently bring a hemodynamic compromise. We describe a case of successful radical pericardiectomy for postoperative constrictive pericarditis using a "T-shaped" thoracotomy in a 68-year-old male patient who had a right IMA graft to the left anterior descending coronary artery.