A 70-year-old man presented with severe angina pectoris caused by critical stenosis of the left anterior descending coronary artery 11 years after mediastinal radiation therapy, esophagectomy and substernal colon interposition for squamous cell carcinoma of the esophagus. Coronary artery bypass was performed through a left thoracotomy using the left internal mammary artery with profound hypothermia. This uncommon approach to an unusual case is described here.
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