BACKGROUND: Minimally invasive surgical approach for OPCABG in terms of by using inferior limited mini-sternotomy could benefit for patients in selected category. METHODS: Up-to-date we have operated 18 patients on this technique. Most of the patients were in advanced age and other co morbidities. All patients underwent OPCABG procedure by using inferior sternotomy. In all cases we performed by starting with 5 cm skin incision and sternum opening up to 2nd intercostal space where it could be turned to the left, right or both sides like L- and T-versions. By this way, one can harvest both mammary arteries to revascularize anterior, lateral and posterior walls. The distal anastomosis varied up to 3 depending on target anatomy RESULTS: No in hospital mortality was observed. Conversion to CPB with a full median sternotomy was never required and the anastomosis was carried out through OPCAB mode. The mechanical ventilation time was 3–7 hours. The ICU stay was 13–43 hours. All patients were discharged at 4-6 days after surgery and not observed any complications. CONCLUSION: Limited sternotomy allows to perform single, double and triple vessel revascularization safely off-pump even in high-risk patients
