[A case of ischemic necrosis on anterior chest wall and mediastinitis after coronary artery bypass grafting using bilateral internal thoracic arteries and inferior epigastric arteries].

Coronary artery bypass grafting using bilateral internal thoracic arteries and inferior epigastric arteries was performed in a 72-year-old man with multiple coronary artery disease who had a history of gastrectomy 25 years before. He postoperatively suffered from ischemic necrosis on anterior chest wall and mediastinitis caused by methicillin resistant staphylococcus aureus and aortic rupture. He got over by drainage at twice, hemostasis of aortic rupture and long-term irrigation using vancomycin. We must not perform coronary artery bypass grafting using bilateral internal thoracic arteries and inferior epigastric arteries at same time.