We understand that autoimmune disorders such as Systemic Lupus Erythematosus increases the likelihood of developing coronary heart disease. However, its implications on patients undergoing cardiac surgery is not well understood. Here we present a female patient with SLE who developed coronary artery disease at a young age and underwent coronary artery bypass graft surgery. As SLE is associated with vasculitis, we wanted to understand regarding the choice of conduit as well as its long term patency. Also whether percutaneous angioplasty has a role to play in patients with SLE.