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Fig 1. (A) Patient positioning and instrument placement for thoracoscopic transmyocardial laser revascularization. The camera and grasper are placed laterally in the fifth intercostal space. The instruments and laser hand pieces are placed anteriorly in the fifth intercostal space and the fourth or third intercostal space. (B) Thoracoscopic view of pericardiotomy. (C) Thoracoscopic view of the laser hand piece against the epicardium.