We detected an infrarenal abdominal aortic aneursym AAA (6.1cm) on a 70-year-old man with triple vessels disease. Coronary operation was scheduled prior to AAA repair. On the postoperative 6'th month, aneursym size reached upto 7.1cm. Due to Chronic Obstructive Pulmonary Disease (COPD), we have had problems in weaning and experienced serious respiratory problems. Prior to AAA repair, pulmonary function tests were worst than before. We considered that postoperative weaning could be imposible. For this reason, Combined Spinal Epidural Anesthesia (CSEA) was prefered to avoid entubation. Although this approach hampers surgical exposure we consider that this method can be used in cases with severe pulmonary problems.