A 60-year-old male was referred to our institution for investigation of intractable hypertension. Coarctation of the aorta was detected by computed tomography (CT). Bilateral internal thoracic arteries played an important role as a collateral source to the lower extremity. Coronary angiography showed stenosis at the ostium of left main trunk. Ascending aorta to bilateral external iliac artery bypass grafting and off-pump coronary artery bypass grafting (OPCAB) was done simultaneously, this is because we had to harvest left internal thoracic artery as a conduit for coronary artery bypass grafting(CABG).Postoperative course was uneventful. The patient was discharged 10 days after the operation. We could perform less-invasive surgery despite the simultaneous operations.
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