Diffuse atherosclerosis of thoracic aorta involving supraaortic and coronary arteries: single-stage surgical revascularization.

Arterial occlusive disease of supraaortic vessels, particularly the subclavian and innominate arteries, is infrequent. Hemodynamically significant proximal lesions of all supraaortic arteries are uncommon and the combination with coronary artery disease is even rarer. So far, the surgical management and operative timing of patients with coexisting severe disease of brachiocephalic and heart vessels is still a matter of debate. We report the case of a patient with severe polydistrectual atherosclerosis treated with single-stage aorto-carotid, carotid-subclavian and aortocoronary bypass.