A female patient, 73 years of age, who underwent CABG for the RCA and First Diagonal Branch by SVG 39 months ago was readmitted to our clinic after an onset of acute angina pain, whereupon successful PTCA was performed to Cx segment 13. However, with the angina pain continuing unabated, and with the recognition through emergent CAG that the graft to the RCA was occluded. PTCA was performed again to the RCA segment 1. The segment was closed off by dissection. The emergent CABG was carried out via femoro-femoral extracorporeal circulation and intra aortic balloon pumping. This CABG was of a RCA to RCA bypass nature, with SVG performed with the heart "beating" and without cooling. The patient was thus relieved of her angina pain and her cardiac function has since been in good order.