Surgical Approaches

  • Denis Berdajs
  • Marko I. Turina


The patient is in the supine position. The skin incision is made in the presternal region of the anterior median sulcus (Figs. 2.1 and 2.2), starting one to two finger-breadths under the suprasternal notch and extending to a point located two finger-breadths under the xiphoid process into the linea alba. The subcutaneous adipose tissue should be dissected by cauterization. The small veins on the anterior surface of the sternum, belonging to the venous drainage of the anterior jugular vein, must be coagulated (Figs. 2.3 and 2.4). Special attention must be paid to dissection of the subcutaneous adipose tissue of the suprasternal notch and of the sternocostal angle (Figs. 2.5 and 2.6).


Latissimus Dorsi Internal Thoracic Artery Rectus Sheath Intercostal Muscle Pectoralis Major 
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© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Denis Berdajs
    • 1
  • Marko I. Turina
    • 2
  1. 1.Department of Cardiovascular SurgeryCentre Hospitalier Universitaire Vaudois, CHUVLausanneSwitzerland
  2. 2.University Hospital ZürichZürichSwitzerland

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