Surgical treatment for patients over the age of forty with coronary aneurysms associated with Kawasaki disease is rare. We report on a 47-year-old man who underwent coronary artery bypass grafting using the left internal thoracic arteries (ITA) and right gastroepiploic (GEA). The postoperative course was uneventful. One month later, the normal stress thallium-201 myocardial perfusion imaging was normal and coronary angiography showed good patency for the ITA, GEA, and saphenous vein grafts. He had some coronary risk factors including smoking, hypertension and hyperlipidemia. Histological examination of a sample shows that the coronary artery sequelae of Kawasaki disease have already become part of increasing burden of adult ischemic heart disease.