Graft replacement for aortic arch aneurysm and concomitant coronary artery bypass grafting were performed in three patients between January 1994 and December 1998 in our department. The etiology of the aneurysms was arteriosclerosis in 2, and aortic dissection in 1 patient who underwent aortic root replacement (Cabrol procedure) simultaneously. Saphenous vein grafts were anastomosed to the coronary artery during core cooling, and selective cerebral perfusion was performed during reconstruction of the aortic arch and arch vessels in all cases. All patients are well and no complications were observed postoperatively.