Sternotomy. Leave pericardium closed until LIMA take-down. Saphenous vein harvest.

Heparin after vein exposed/adequate length available.

Cannulation. U-stitch for placing root vent/replacing with proximal anastomosis site.

Bypass. X-clamp. Run the plegia.

Prepare the vein graft/apply ligaclips. Estimate segments for targets. Fashion vein tip for anastomosis. Keep vein away. Ensure vein is not connected to the syringe which may be dropped on the floor.

Identify targets. Wet swabs.

Order:PDA, OM, Int (as OM) Diagonal, LAD.

Remove bulldog on the mammary after the anastomosis.