Objective: In patients with severe coronary artery disease (CAD), the risk of tumor surgery under general anesthesia is high, and whether coronary revascularization should be prioritized remains debatable, considering tumor prognosis. We aimed to analyze surgical outcomes for severe CAD with malignancy. Materials and Methods: We analyzed 20 patients with malignant tumors and 256 who underwent coronary artery bypass graft surgery (CABG) at our hospital to investigate early and long-term outcomes. We also conducted propensity score analysis. Results: No significant differences were observed in preoperative background. Patients with malignancy had significantly fewer lesions and bypass grafts. There was no significance in postoperative complications or cardiac events. After propensity score matching, results were similar. Treatment for malignancy was performed safely post-CABG. However, two patients could not undergo scheduled treatment because of change in their clinical condition after CABG. Conclusion: CABG in patients with malignancy was safely performed and prevented postoperative cardiac events. Because postoperative status can be changeable, cancer team management should be considered for all CABG cases with malignancy.
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