New technique Right Anterior Small Thoracotomy (RAST operation) for beating heart grafting of the right internal thoracic artery to the posterior descending artery to the posterior descending artery in a third redo CABG patient. A novel coronary technique

Third REDO-CABG is a challenge for the surgical team. Usually a patent mammary is theonly graft working and the sternotomy becomes a risky procedure. Injury to a patentgraft has been associated to a high mortality rate. Many different approaches havebeen proposed. We describe a novel technique to approach the right coronary arterythrough a right anterior small thoracotomy using the right mammary prolonged withsaphenous vein for grafting the posterior descending artery on the beating heart. Thetechnique is very simple and feasible because anatomically the right coronary arteryand the right mammary are very close and the mobilization of the heart isminimal.