Fluoroscopic angiography-guided mini-entry localization before minimally invasive redo coronary artery bypass

We have been using a mini-thoracotomy localization technique before re-operative minimally invasive direct coronary artery bypass (MIDCAB) to the left anterior descending artery (LAD). This technique was performed during the diagnostic laboratory catheter study, in which the skin portion was marked just above the target LAD site, observing the enhanced LAD by fluoroscopy. In nine patients, a 3-4-cm mini-entry was made by referring to the marked position, the LAD was identified in the minimally dissected epicardium, and anastomoses were performed using the vein in six cases, the left internal thoracic artery in two, and the right gastroepiploic artery in one.