A case report of an operation after CABG and AVR was presented. The patient was a 52-year-old female. She underwent CABG with saphenous veins at 43 years old and AVR at 45 years old. She was admitted to our hospital due to acute myocardial infarction. Coronary angiography revealed that all the native coronary arteries were occluded at the proximal side, two grafts to RCA and CX were occluded, and LAD graft had a 99% stenosis. She became critically ill due to low cardiac output and acute renal failure. Endoartrectomy of the LAD graft was performed under CPB. Early postoperative course was uneventful. Severe ST depression in the pre-operative ECG normalized in the postoperative ECG. But she had a chest pain again in the 4th postoperative week. She became critically ill and died on the 43rd postoperative day. It was thought that redo CABG should have been performed after her condition improved.