2. Sternotomy. It’s important to be midline. The cut can be crania-caudal, or the opposite. Here we see cranio-caudal. The surgeon stands on the right side of the patient. First, we place a finger under the sternum in the notch, and then under the xiphoid. It’s important to develop that space.

1. 1. The skin incision. The median sternotomy is the most common way to access the heart. The incision needs to be centered over the sternum. To achieve this, I mark the sternum with a line prior to draping. (Draping moves the skin, unless you drape cranio-caudal). Typically a #10 blade is used.

0. Cardiac surgery is modular. It has many individual steps that must be mastered to get an operation done. I will attempt, in my posts, to break down the steps so you can understand an operation from start to finish.