A combined operation of coronary revascularization, abdominal aortic aneurysmectomy and femoro-popliteal bypass

A 71-year-old male with abdominal aortic aneurysm, coronary artery disease and obstructive peripheral arteriosclerosis successfully underwent a combined operation of coronary artery bypass grafting (CABG), replacement of abdominal aortic aneurysm and femoro-popliteal bypass. In this combined operation, the right gastroepiploic artery (GEA) is suitable as a bypass graft, because a laparotomy is required for abdominal aortic aneurysmectomy. And the usage of arterial grafts such as GEA and the left internal thoracic artery (LITA) is reasonable in terms of avoiding hazardous proximal anastomosis and reducing the operating time.