A 65-year-old man applied to our hospital with efor angina that have progressive raised for last 6 months. He had undergone coronary bypass operation three years ago. Also he has diabetes and hypertension. Owing to his typical symptoms a coronary angiogram was performed. In his coronary angiogram left anterior descending arter (LAD) was totally occluded at mid-level, circumflex and right coronary arteries (RCA) and aort-obtus marginalis (OM), saphenous graft were open (Fig. 1). A retrograd flow was seen between aort- diagonal grafts to left subclavian artery (LSA) through to left internal mammarian artery (LIMA) (Fig. 2A-C, Video 1, 2). Attempts was failed to demonstrate LIMA due to total occlusion of LSA (Fig. 2D, Video 3). LIMA originates from LSA. In case of LIMA graft an occlusion or severe stenosis of LSA causes retrograd flow from coronary arteries to left upper extremity as a consequence myocardial ischemia. Mostly retrograd flow comes from native LAD through to LIMA. In our case a saphenous graft provides connection between ascending aorta to LSA by using diagonal artery, LAD and LİMA. We consider diffuse illness of distal LAD may support that retrograd flow. We suggest that checking LSA and LIMA before the bypass operation could provide that undesirable results.