Simultaneous carotid endarterectomy, coronary artery bypass grafting and abdominal aortic aneurysm surgery.

A case with a disease triad of an ulcerative lesion in the left internal carotid artery (LICA), severe coronary insufficiency, and an infrarenal abdominal aortic aneurysm (AAA) is presented in whom we performed simultaneous carotid endarterectomy (CEA), coronary artery bypass grafting (CABG), and Y-graft replacement of the AAA. The operative technique is detailed and justification of the simultaneous approach in such patients is discussed.