[Aortic bicarotid subclavian trifurcation bypass grafting combined with coronary aortic bypass grafting].

Presented herein is the result of a successful simultaneous operation: carotid endarterectomy on the left + aortic-carotid prosthetic repair on the left + prosthetic repair of the brachiocephalic trunk + graft-subclavian bypass procedure on the left + graft-coronary bypass prosthetic repair of the anterior descending artery with an autovein and coronary aortic bypass grafting of the right coronary artery with an autovein. The chosen method of surgical correction was characterized by a high level of technical difficulty. Retrospectively, the correctness of the implemented surgical policy was confirmed by the worked out in our institution automated decision-making support system for choosing optimal strategy of revascularization in multifocal atherosclerosis. The carried out treatment made it possible to obtain a satisfactory result persisting over a one-year period of follow-up, having prevented unfavourable ischaemic cardiovascular complications in an extremely-difficult-to-cure patient.