Simultaneous multiple organ revascularization in patient with severe diffuse atherosclerotic disease

Atherosclerotic coronary artery disease is frequently accompanied by similar changes in other vital arteries such as the carotid and renal and this may complicate the problem of clinical management. We report a patient suffering from diffuse severe atherosclerotic disease affecting the coronary vessels, right brachicephalic artery and both renal arteries. He developed symptoms of severe myocardial ischemia together with recurrent transient cerebral ischemic attacks, and severe renal hypertension. The patient was subjected to a combined procedure in which a right carotid endarterectomy, triple aortocoronary bypass - grafting, and a bilateral renal endarterectomy were performed. His post-operative course was uneventful and complete relief of all his symptoms and signs was achieved.