48 years old male who was reffered to us for coronary artery bypass graft,was scheduled for surgery and during the operation it was found that the patient is suffering from Takayasu arteritis. Patient had no suitable left internal thoracic artery for revascularizaton, so ,saphenous veins and off-pump coronary artery by pass graft were used for revascularization .The case is presented below and the cardiac manifestations and challenges in these patients is discussed.
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