Video-assisted harvesting of internal thoracic artery through median sternotomy incision in pectus excavatum

Pectus excavatum is the most common deformity of the chest wall, in which the sternum and ribs show an abnormal growth. This pathology may complicate the operative exposure and manipulation during LITA harvesting through the median sternotomy incision in coronary artery bypass surgery. A 60-year-old female patient with three-vessel coronary disease and pectus excavatum was admitted. The patient underwent myocardial revascularization through median sternotomy, however, the exposure of the left internal thoracic artery was unsatisfactory due to the pectus deformity. Therefore, a 30-degree endoscope was successfully used for in situ harvesting of the left internal thoracic artery. In conclusion, the use of an endoscope is a safe and feasible solution for in situ internal thoracic artery harvesting in patients with pectus deformity who undergo coronary artery bypass grafting using sternotomy.