A 58-year old patient who had undergone repair of aortic coarctation at 19 years of age, subsequently developed coronary artery disease requiring coronary artery bypass surgery. At operation both internal mammary arteries were found to be totally occluded with calcific atherosclerosis. We therefore advise that the internal mammary arteries should be assessed carefully in patients with similar past histories. (C) 1997 Elsevier Science B.V.