Substernal thoracoscopic guidance during sternal reentry

Reentry sternotomy is commonplace, as more patients are returning for secon d, third, or more repeat cardiac procedures. Catastrophic hemorrhage remain s the most dreaded complication during reentry and carries a significant mo rbidity and mortality. Although various methods are used to reduce the risk of hemorrhage, we have found that substernal thoracoscopy is preferable. O ur experience with this technique in both adults and children is presented. (C) 2001 by The Society of Thoracic Surgeons.