SUMMARY
Thymoma in patients with coronary disease is rare. Although simultaneously performing a cardiac procedure and thymectomy for patients with combined thymoma and cardiac disease has been reported, a clear consensus regard- ing the optimal surgical treatment is lacking. Moreover, in all of the previously reported cases, the surgical intervention and standard cardiopulmonary bypass were performed simul- taneously. We present the case of a patient who underwent combined off-pump coronary artery bypass grafting (CABG) and thymectomy. We show that this combined procedure is the treatment of choice for patients with a severely ischemic myocardium and a malignant thymoma.