Direct-vision retrosternal dissection using the Kent retractor for sternal re-entry.

Repeat median sternotomy is still associated with high morbidity and mortality from catastrophic hemorrhage or myocardial injury. To overcome these problems, we devised a new technique of sternal re-entry using the Kent retractor set (Takasago Ika Kogyo, Tokyo, Japan), which increases the safety of retrosternal dissection and sternal redivision.