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Cardiac surgery requiring resternotomy (so-called ‘redo’ surgery) is technically difficult and carries a higher operative risk than a first-time operation. The particular problems are well recognised and include difficulty with access to the heart (due to adhesions, scarring, fibrosis or calcification around the operative site) making dissection and suture placement difficult, prolonged operation times and increased postoperative mortality and morbidity.It covers the spectrum of redo cardiac operations, including coronary artery bypass, mitral valve repair, reoperation for prosthetic mitral valve endocarditis, aortic arch reoperation, descending and thoracoabdominal aortic reoperation, and reoperations following endovascular aortic repair. All redo cardiac surgeries present a complex array of challenges beyond what the original procedure demands.

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