Authors present the case report of a young man with advanced coronary artery disease of the left main trunk, and the large tributaries of the left coronary system, leading to sudden onset of many ventricular fibrillation, associated with unconsciousness requiring several reanimation. The condition was treated with coronary artery surgery with the use of three different arterial conduits (right radial artery, right gastroepiploic artery as free grafts and the left internal mammary artery in situ) with an additional saphenous vein bypass graft. Details of surgical activity as well as the documents of the early postoperative course and of the 1 month follow-up are described.