Left upper lobectomy in a patient with a history of Left Internal Mammary Artery (LIMA) graft for Coronary Artery Bypass Graft surgery (CABG) is a challenge for the surgical team. The adhesion formation in the left chest, especially around the left internal mammary artery graft, may cause diffculty for surgery. The injury of LIMA during dissection may lead to serious acute myocardial ischemia and cardiac arrest. The authors reported a case of successful operation after receiving both good surgical and anesthetic plan prior to surgery.
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