Five patients underwent aorto-coronary saphenous vein bypass graft simultaneously with other necessary arterial reconstructive procedures: (1) ascending aortorrhaphy for dissecting aneurysm; (2) resection of left ventricular and aorto-iliac aneurysms; (3) patch graft for stenosis of the origin of the right vertebral artery and endarterectomy of the right common carotid; (4) resection of ascending aorta and replacement of aortic valve for aortic aneurysm; and (5) Dacron bypass from ascending aorta to subclavian and common carotid arteries. Despite the length of the operative procedure (one was 11 hours) all survived and were doing well on discharge. One died three months later at home.