Esmolol resistance during anesthesia for thoracoscopically assisted coronary artery bypass grafting

The anesthetic technique for two patients who underwent thoracoscopic harvesting of the LIMA followed by a mini-thoracotomy for surgical myocardial revascularization of isolated LAD artery stenosis is reported. Both patients unexpectedly showed esmolol resistance during anastomosis of the LIMA to the LAD artery. However, excellent graft patency, early extubation, and rapid recoveries were achieved.