Preservation of the lima pedicle after cardiac surgery in left upper lobectomy

Left internal mammary artery (LIMA) harvesting for coronary artery bypass grafting often complicates future thoracic procedures because of adhesion formation in the left chest and to the left upper lobe. We describe an adjuvant approach to left upper lobectomy for bronchogenic carcinoma in a patient with previous LIMA harvesting and grafting in which we preserved the LIMA pedicle, while still providing near complete lobe resection.