Fig. 1

Surgical procedure. A LITA retractor (THORATRAK MICS Retractor System) was used to expose the chest wall space for LITA takedown and proximal anastomosis. B ValveGate™ Hinged retractor was used for LITA trimming and distal anastomosis. C Customized vascular clamp (Cardiomedical GmbH, Langenahgen, Germany) was placed on the ascending aorta for proximal anastomosis. D Octopus stabilizer (29800 Medtronic Inc., Minneapolis, MN, USA) was used for the exposure of deeper sites such as the obtuse marginal branch