Selective and adjustable pericardial flap to protect internal mammary artery grafts

We describe the surgical technique of a localized and adjustable pericardial flap to protect internal mammary artery grafts. This flap allows selective pulmonary retraction, maintains pleural integrity, and saves most of the pericardium for later closure. This technique has proved to be simple and highly effective. We have used it in 80 patients and have not had any related complications.