Severe vascular lesions involving the heart and brain vessels are a common cause of high-risk complications, and complications from the simultaneous involvement of two important organs are often fatal. Recently, a middle-aged male patient from Henan Province faced exactly the above two conditions and was waiting for timely treatment. The patient’s preoperative coronary angiogram showed severe stenosis in multiple branches of the coronary arteries, combined with old myocardial infarction, which could not be treated with stents and required “coronary artery bypass grafting”. At the same time, carotid angiography showed complete occlusion of the right common carotid artery and 90% stenosis of the left internal carotid artery, which means that the blood supply to the brain relies only on the highly stenosed internal carotid artery and the collateral circulation, and there is always a risk of occlusion and a large brain infarction. The treatment of carotid stenosis requires “carotid endarterectomy”. After receiving the patient, Prof. Liu Luqi analyzed that this patient might have a life-threatening “heart attack” if the neck surgery was performed first, and a life-threatening “brain attack” if the heart bypass surgery was performed first. This is a routine choice in many large hospitals in China. Prof. Liu Luqi mastered carotid endarterectomy when he studied abroad and assisted our brain surgery department to carry out this operation. Therefore, it was decided to perform both surgeries on this patient at the same time. The operation was performed by Director Liu Luqi, and it took 5 hours to successfully complete carotid artery stripping angioplasty and simultaneous non-stop coronary artery bypass grafting. The procedure was smooth and the postoperative recovery was smooth without any complications, and the patient was discharged happily. This difficult and high-risk operation has accumulated valuable treatment experience for our specialists. (Correspondent: Zhang Hui)