Catastrophic hemorrhage during redo sternotomy

This paper reviews the attitude of 131 surgeons to the performance of a second sternotomy incision and assesses 144 severe hemorrhages that occurred as the sternotomy was being done. Eighty-eight percent of the hemorrhages occurred in situations in which the pericardium had not been closed at the first operation. From these events and the present attitude of surgeons responding to our questionnaire, we offer advice on the management of second sternotomies and on the management of hemorrhage when it occurs.