A 77-year-old man with diabetes, dyslipidemia, and a smoking history presented with asymptomatic gross hematuria and left hydronephrosis. Computed tomography (CT) angiography revealed a left ureteral tumor and abdominal aortic aneurysm. Cardiac catheterization revealed right coronary artery (RCA) stenosis. First, a left nephroureterectomy was performed via a midline abdominal incision. To achieve minimal invasiveness, a median sternotomy was avoided, and off-pump coronary artery bypass grafting of the RCA was performed with the great saphenous vein graft, using the left renal artery as the graft inflow. Y-grafting was subsequently performed. Without any postoperative complications, CT angiography confirmed graft patency. This procedure has potential use for removing ureteral tumors by surgeons and clinicians in clinical settings.