[Modification of repeat lateral minimally invasive direct coronary artery bypass; left axillary artery to circumflex artery bypass].

A 69-year-old man underwent triple coronary artery bypass graftings [LITA (left internal thoracic artery)-LAD (left anterior descending artery), SVG (saphenous vein graft)-PD (postac-descending artery), SVG-PL (postero-lateral artery)] 11 years previously. Recently, angina pectoris occurred due to the graft disease of SVG-PL. A repeat modified lateral minimally invasive direct coronary artery bypass (MIDCAB) [left axillary artery-PL using SVG] was performed. The left axillary artery was chosen as inflow vessel for coronary artery bypass graft because of the difficult descending aorta and patent LITA-LAD. Postoperative course was uneventful. The left axillary artery to circumflex artery bypass could be one of the option of the lateral MIDCAB.