AbstractPatients with symptomatic left subclavian artery stenosis (LSA), often undergo intervention. The need for intervention in incidentally detected LSA stenosis in patients undergoing coronary artery bypass grafting (CABG) is controversial. We evaluated an elderly male with triple vessel coronary artery disease and borderline stenosis in LSA. Bilateral internal thoracic artery (ITA) conduits were harvested and right ITA – left ITA ‘Y‘ grafting was done. This approach can be considered as an alternative for patients undergoing bypass surgery with asymptomatic LSA stenosis to prevent coronary subclavian steal syndrome.