A 61-year-old man with unstable angina due to complete occlusion of the proximal LAD underwent MIDCAB (left internal thoracic artery (ITA)-left anterior descending artery (LAD) anastomosis), because of active hepatitis and unsuccessful PTCA. The left fourth intercostal mini-thoracotomy (9 cm long) was performed. The left ITA was harvested through the thoracotomy. The left ITA to LAD anastomosis under the beating heart was successfully performed using Mini-CABG instruments (USSC). Postoperative recovery was uneventful and postoperative coronary angiography on the 5th postoperative day revealed a widely patent graft. The patient was discharged on the 8th postoperative day. This device was very useful to perform the MIDCAB procedure.