• Reproducible surgery • Low mortality and early complications rate • Good early, mid and long-term results Take-home message The left thoracotomy is a safe alternative to median sternotomy for coronary artery bypass grafting on the beating heart, with low early complications and good mid and long-term results.

The Glenn operation involving anastomosis of the superior vena cava to the pulmonary artery has been performed for palliative operations of many cyanotic congenital heart diseases in addition to the single ventricle since the 1960s. The classic procedure is done via median sternotomy and cardiopulmonary bypass. The benefits of this procedure without the use of cardiopulmonary bypass remain mixed within reported series. Cases using this approach and off-pump technique together in Latin-America have not yet been reported in the scientific literature.

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