The best surgical approach for patients presenting with coarctation of the aorta and additional surgical cardiovascular disorders is uncertain. We describe the case of a young man with an aneurysm of the ascending aorta and a bicuspid aortic valve with a moderate insufficiency associated with a coarctation of the aorta. The patient underwent a single-stage procedure where the ascending aorta was replaced, the aortic valve repaired and the coarctation bypassed with an extra-anatomic graft. In our opinion, ascending-to-descending extra-anatomic graft is a good solution to treat these complicated cases.