Arterial conduits should be evaluated preoperatively in coronary artery bypass patients with pseudoxanthoma elasticum.

A 74-year-old man who had pseudoxanthoma elasticum presented with unstable angina and underwent urgent coronary artery bypass grafting. Preoperative angiography did not include the internal mammary arteries. Intraoperatively, the left internal mammary artery was found to be diseased and could not be used. This case lends support to the need for thorough preoperative evaluation, including angiography, of potential arterial conduits in patients with pseudoxanthoma elasticum.