Abstract
Abstract Pectus arcuatum, also known as Currarino-Silverman syndrome or pouter pigeon breast, is a rare disorder characterized by premature fusion of manubrio-sternal joint and the sternal segments. This condition may cause an abnormally short sternum with forward angulation at the Louis's angle resulting in a severely protruding upper sternum combined with depressed lower sternum. Pectus arcuatum may be associated to cardiac diseases requiring surgery. Access to the heart may be complicated by the chest wall deformity. In this video we present a case of a 75 years-old man who suffered from ACS-NSTEMI with coronary disease and pectus arcuatum. An off-pump single CABG using LIMA to LAD was peformed. SVG interposition was necessary due to difficult mammary harvesting in the protruding upper sternum. Here is shown the access to the mediastinum by an oscillating sternal saw, the application of a small sternal retractor, the pericardial opening and chest closure.
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