Reoperative median sternotomy using a cast spreader

Repeat median sternotomy carries a high mortality rate secondary to a highe r incidence of injury to the underlying vital structures. The reported inci dence of reentry accidents may be as high as 6% to 10%. We describe a new t echnique of redo sternotomy using a nitrogen-powered oscillating saw and a cast spreader. The new technique was used for 89 consecutive cases without any incidence of injury to the underlying structures. The use of a case spr eader during repeat median sternotomy may enhance the safety of reentry.