We report a 68 old male, who underwent coronary artery bypass using left internal mammary artery, right gastroepiploic artery, and saphenous vein graft and ascending aorta to bifemoral bypass using polytetrafluoroethylene graft, under the diagnosis of severe three coronary arterial disease and bilateral occlusive illiac arterial disease. The procedure of ascending aorta to bifemoral bypass is considered to have the advantage compared with traditional femoral by passes especially combined coronary and femoral arterial revascularization is needed.