Triple Threat Surgery: Combined Aortic Valve Replacement, Coronary Artery Bypass Grafting, and Liver Transplantation in a Case of Hepatocellular Carcinoma

Liver transplantation in patients with significant cardiac disease presents considerable challenges due to increased morbidity and mortality. Sequential cardiac surgery followed by liver transplant has traditionally been recommended, yet some centers now perform combined or concomitant cardiac surgery and liver transplant within the same setting. Both approaches carry high intra- and peri-operative risks. We present a case where aortic valve replacement, coronary artery bypass grafting, and living donor liver transplant were performed in a single setting for a patient diagnosed with hepatocellular carcinoma.