Ascending aorta replacement with concomitant coronary and peripheral artery bypass grafting

Atherosclerosis of the aorta is a well-known risk factor for peri-operative complications in patients undergoing cardiac surgery. Coronary and peripheral artery bypass procedures can be challenging when the native aorta is not amenable to bypass grafting due to severe calcification. We describe the successful management of a patient who underwent ascending aorta replacement with concomitant three-vessel coronary artery bypass, bilateral aorto-axillary bypass and left axillary-to-carotid bypass.