Totally Arterial Off-pump Coronary Artery Bypass Grafting after Pneumonectomy

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We report the case of an 82-year-old man who underwent triple coronary artery bypass grafting with arterial grafts, who 20 years previously underwent left pneumonectomy for lung cancer. Computed tomography (CT) presented a marked shift of the heart and great vessels into the left hemithorax. Off-pump coronary artery bypass grafting was performed through a left thoracotomy, in which the left internal thoracic, right gastroepiploic, and radial arteries were used. He was extubated 1 hour post-operatively and had an uneventful recovery.