A seventy-two-year-old male patient was diagnosed to have major three kinds of atherosclerotic disease including transverse aortic arch aneurysm, ischemic heart disease and stenosis of left external iliac artery. Complete graft replacement of aortic arch was performed concomitantly with the coronary arterial bypass grafting and iliofemoral bypass grafting under selective cerebral and coronary perfusion technique. In addition, the graft used for iliofemoral arterial reconstruction was tailored to have two branches, which facilitate the insertion of the inflow cannula for a bypass and the occlusion balloon catheter. His postoperative course was uneventful and was discharged under a satisfactory condition.