Left thoracotomy for coronary bypass in a patient with pectus excavatum

In a patient with pectus excavatum, coronary artery bypass grafting with the internal mammary artery is difficult or even impossible through a median sternotomy. We suggest and describe an anterolateral thoracotomy that, in this particular case, not only allowed taking the internal mammary artery but also provided an excellent exposure of the anterolateral aspect of the heart.