For patients awaiting urgent total laryngectomy who require coronary artery bypass grafting (CABG), the conventional median sternotomy should be avoided. We present a 69-year-old male who had urgent CABG as a prelude to an urgent laryngectomy for recurring laryngeal carcinoma. We recommend a manubriumsparing T-shaped ministernotomy to preserve tissues and to avoid the disruption of the anatomy of the lower neck and superior mediastinum.
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