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Coronary angiography revealed stenotic lesions affecting all three coronary arteries. Multislice 3D contrast-enhanced computed tomography (CT-scan) revealed a 36 \u00d7 27 mm AAP. Endovascular stent-grafting was deemed to be unsuitable due to hostile landing zone. Therefore, the heart team decided for simultaneou treatment of the AAP and percutaneous therapy of CAD. The AAP was excised, and repair was performed with a Dacron patch on beating heart. After the surgical procedure, PCI with drug-eluting stents (DES) was performed on the right coronary artery (RCA) and the left circumflex artery (LCx) in the operating room. The patient's postprocedural course was uneventful and after thirteen days, he was discharged in good shape. 3D CT-scan performed after three month showed no residual AAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We established this approach as being the most suitable for our case based on favorable circumstances such as: stable CAD, beating heart procedure with low impact on myocardial ischemia, the impossibility of successful placement of an endovascular stent-graft, the presence of a pseudoaneurysm neck with minimum calcification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We consider the best approach for individual cases is tailoring the treatment plan and the procedure to the patient's specific anatomy and pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.07.085","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T21:30:39Z","timestamp":1597440639000},"page":"86-90","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Successful concomitant open surgical repair of aortic arch pseudoaneurysm and percutaneous myocardial revascularization in a high risk patient"],"prefix":"10.1097","volume":"74","author":[{"given":"Roxana Carmen","family":"Geana","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu","family":"Stiru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Raducu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Tulin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina","family":"Parasca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolae","family":"Bacalbasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad Anton","family":"Iliescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20-20260114","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S1474-4422(04)00806-3","article-title":"Atheroma of the aortic arch: an important and poorly recognised factor in the aetiology of stroke","volume":"3","author":"Macleod","year":"2004","journal-title":"Lancet Neurol"},{"key":"R2-20-20260114","doi-asserted-by":"crossref","first-page":"397","DOI":"10.21037\/acs.2018.04.09","article-title":"Cerebral embolic protection during endovascular arch replacement","volume":"7","author":"Herman","year":"2018","journal-title":"Ann. 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