ABSTRACT
Cervical reconstructions[2] are less risky than transthoracic reconstructions,[3] but in the more complex cases with two-or three-vessel involvement the long-term prognosis of a cervical reconstruction is inferior to that of a transthoracic one. The thoracic route should be avoided if possible in patientswho have had myocardial revascularization because of the possibility of injury to functioning coronary bypass grafts. Lesions of the innominate artery deserve special consideration when they are emboligenous because the proximal innominate artery needs to be surgically excluded from the path of flow, and this may be a difficult thing to accomplish through a cervical approach.
