Off-pump combined coronary artery bypass grafting and left upper lobectomy through left posterolateral thoracotomy

A 61-year-old man with angina had a lesion in the left upper lobe of his lung on chest roentgenogram. Coronary angiography revealed a dominant circumflex lesion. Combined coronary artery bypass grafting (CABG) and left upper lobectomy was performed through left posterolateral thoracotomy without the use of cardiopulmonary bypass. Off-pump CABG abolishes the complications of cardiopulmonary bypass, while posterolateral thoracotomy provides a direct access to the circumflex vessels and is ideal for lung resection.