RESUMEN
A 77-year-old man with a history of cerebral infarction was admitted to our hospital with chest oppression. Coronary angiography revealed 2-vessel disease involving left main trunk. Coronary artery bypass grafting to left anterior descending artery and obtuse marginal branch was scheduled, but the patient developed hemiparesis and the scheduled coronary artery bypass grafting was postponed by at least one month. Unfortunately, the patient complained of severe chest pain at midnight of the second day from the onset of the neurological deficits and went into cardiogenic shock. We performed off-pump coronary artery bypass grafting to left anterior descending artery on the 5th day from the onset of the neurological deficits. His postoperative course was uneventful. Off-pump coronary artery bypass grafting is appropriate as an alternative procedure for high-risk patients with recent neurological deficits.