Background
Combined ONCAB and SAVR is the treatment of choice for concomitant severe aortic stenosis and coronary artery disease not amenable to PCI intervention. Extensive aortic calcification and atheromatous disease may prohibit cardiopulmonary bypass and aortic cross clamping. In these cases Anaortic OPCAB is a Class I (EACTS 2018) and Class IIA (AHA 2021) indication for surgical coronary revascularization. TAVR has similar benefits when compared to SAVR for this population (Partner 2 & 3). Herewith we describe a case series of concomitant Anaortic OPCAB and TAVR via the transfemoral approach for patients with coronary artery and valve disease considered too high risk for traditional CABG and SAVR due to severe aortic disease.