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Coronary heart disease is more prevalent in Indian urban populations and there is a clear declining gradient in its prevalence from semi-urban to rural populations. Epidemiological studies show a sizeable burden of coronary heart disease in adult rural (3-5%) and urban (7-10%) populations.

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Coexistent aneurysms of the coronary and inominate arteries are extremely rare. We present the case of a 28-year-old male with an aneurysm of the left anterior descending coronary artery and an aneurysm of the inominate artery presenting with hoarseness and severely depressed left ventricular function (ejection fraction of 25%). He underwent successful surgical resection of both aneurysms. The inominate artery aneurysm was excised and the brachiocephalic trunk was reconstructed off-pump. The coronary artery aneurysm was excised and distal aorto-coronary bypass grafting was done on cardiopulmonary bypass.

Vascular trauma results from penetrating, blunt or iatrogenic injuries. Young males are at highest risk and the leading causes of injury include motor vehicle crashes, falls, wounds from firearms, wounds from cutting or piercing instruments and burns. Peripheral vascular injuries account for 80% of all cases of vascular trauma. We report the case of a 21-year-old male patient with history of fall from 10 feet height on to a sharp metallic plate. Patient presented to emergency department with a lacerated wound of 15 x 10 cm on right mid thigh with active pulsatile bleed. After fluid resuscitation, patient was immediately shifted to operation room where examination revealed complete transaction of superficial femoral artery and vein with 10 cm tissue loss of both. Both vessels were reconstructed using saphenous venous graft from opposite thigh. Postoperatively, patient made a steady recovery with strong pedal pulsations and no edema or neurological deficit. Patients with hard signs of arterial trauma should be taken for surgical exploration without any diagnostic investigations. Traumatic muscular lacerations with gross contamination of wound precluded the use of any prosthetic graft and hence saphenous venous graft was most appropriate. Review of literature reveals that patients with concomitant peripheral arterial and venous injuries have a very high amputation rate and simultaneous reconstruction of both leads to improved chances of limb salvage. It is our recom mendation that such patients should receive postoperative anticoagulation to avoid thrombosis of graft in venous position.