"Pulmonary slit" procedure for preventing tension on the left internal thoracic artery graft

The gold-standard bypass graft to the left anterior descending coronary artery is the left internal thoracic artery harvested with its pedicle. At times, however, the length of the internal thoracic artery is insufficient for distal anastomosis. Different methods of lengthening the internal thoracic artery or of reducing the distance to the anastomosis site have been described, but at times even these may be inadequate. In order to extend the benefits of the left internal thoracic artery graft to more patients, we perform the "pulmonary slit" procedure as described here.