The clamshell incision provides adequate exposure for aortic valve replacement and coronary revascularization

The standard median sternotomy provides ready access to all surfaces of the heart and the ascending aorta. When cosmetic considerations, associated medical conditions, such as an esophageal stoma, or tracheostomy preclude use of the median sternotomy, a bilateral transverse sternotomy will provide excellent exposure of the entire ascending aorta and the lateral and inferior walls of the heart.