Objective Minimally invasive multivessel coronary artery bypass grafting (MIM CABG) has demonstrated its safety, effectiveness and high rate of reproducibility. However, minithoracotomy CABG is still rarely performed. In this study, we retrospectively analyze the CT‐angiographic graft patency rates for the patients subjected to this operation. Methods A total of 245 patients were subjected to MIM CABG by a left minithoracotomy approach between 2014 and 2018. The left internal thoracic artery (LITA) harvesting, proximal, and distal anastomoses were performed under direct vision. The patients then underwent 128‐slice computed tomography coronary angiography (CTA). The angiographic results were obtained for 127 (51.8%) patients (the follow‐up period of 31.1 ± 7.8 months, from 15 to 45 months). Of the total patients, 204 (83.2%) were followed clinically during the time period from 12 to 56 months. Results Complete revascularization was performed for all the patients. The mean number of grafts was 2.6 ± 0.5. The perioperative mortality was 0.4% (1 patient). There were two conversions to sternotomy (0.8%), four reopenings for bleeding (1.6%), three myocardial infarctions (1.2%), and one stroke (0.4%). Twenty‐two patients (9.0%) received transfusions. The long‐term mortality was 4.4% (nine patients). Three patients (1.5%) suffered from a stroke during the follow‐up period. For five patients (2.4%), repeat revascularization was necessary. For the examined patients, the overall graft patency rate was 89.8%, the LITA graft patency rate was 98.4%, the radial artery patency was 100%, and the saphenous vein graft patency was 84.0%. Conclusions MIM CABG allows complete surgical revascularization with excellent clinical outcomes and promising angiographic graft patency rates.

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Background. Ventricular aneurysms develop after transmural myocardial infarctions and can significantly worsen clinical outcomes. We report an unusual case of the giant inferior wall aneurysm, successfully treated by surgical resection. Case presentation. The 65-year-old male was diagnosed with a giant inferior wall left ventricular aneurysm after worsening of his dyspnoea. Four months prior to the admission, he had ST-elevation inferior myocardial infarction, complicated by pericarditis. During the 4-month follow-up period, the aneurysm has significantly increased in size. Unrecognized ventricular wall rupture was supposed.The precise anatomy of the aneurysm was established by cardiac MRI. Surgical resection of the aneurysm was performed with uneventful patient's recovery. Conclusion. Timely surgical treatment of the rapidly growing aneurysms is recommended. In such cases cardiac MRI can specify anatomy and coordinate surgical strategy.