The surgical management of porcelain aorta in patients requiring aortic valve replacement or coronary artery surgery carries a high morbidity and mortality and remains controversial. We report a successful transapical aortic valve implantation in combination with on-pump coronary artery bypass grafting in a young patient with severe aortic stenosis, left main coronary artery disease and porcelain aorta. Transapical aortic valve implantation is a minimally invasive surgical alternative that can be safely performed in combination with coronary artery bypass grafting and may become the treatment of choice, even in young patients with porcelain aorta.