Conclusion
Chest and abdominal wall infarction is an extremely rare complication of BIMA harvesting during CABG surgery, leading to deep sternal wound infection and parietal defect. Butterfly sternal closure technique, pectoralis major flap reconstruction and Vacuum Assisted Closure device therapy can be useful in the management of these challenging complications. Although BIMA has proved its benefits in mid- and long-term survival after surgical coronary revascularization, cautions should be in order in patients with compromised inferior epigastric artery flow.