Internal thoracic artery atherosclerosis after coarctation repair in an adult

We report a rare case of a patient with an unsuitable grossly atherosclerotic and extensively calcified right internal thoracic artery found during a coronary bypass grafting operation. He had undergone an aortic coarctation repair 35 years before, with long-term systemic hypertension previous to the operation and sustained after it. It is advisable to be alert to the possibility of atherosclerotic degeneration of the internal thoracic artery in these patients.