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Total arterial revascularization using bilateral internal mammary artery for coronary artery disease has shown to have excellent long term results.LIMA-RIMA-Y (left internal mammary artery and right internal mammary artery-Y) grafting is traditionally performed through midline stemotomy with sternal healing being an issue in recovery phase.Currently LIMA-RIMA-Y gaffing has also been performed by robotic assistance either for bilateral internal mammary artery harvesting or by performing the complete procedure using a robot.We at our institute are performing total arterial revascularization using LIMA-RIMA-Y grafting (off pump) through left mini thoracotomy approach (MIDCAB) without any robotic or endoscopic assistance.We describe our technique and compare the results with other available techniques of LIMA-RIMA-Y grafting.