Background Patients presenting with several cardiothoracic conditions that need to be addressed surgically require individual decision making as evidence remains inconclusive and combined surgical procedures carry an elevated perioperative risk. Case Description We present the case and management of a 73-year-old male with myocardial infarction due to three-vessel disease and left main stem stenosis, calcified aortic aneurysm, and right-sided non-small cell lung carcinoma. Conclusion High-risk combined surgery should be indicated with scrutiny after individual consideration by an experienced heart team.