Operations through a previous sternotomy incision are associated with significant hazards, including cardiac injury, excessive hemorrhage during and after cardiopulmonary bypass, and postoperative sternal instability. A technique for safely opening previous sternotomy incisions has been developed at New York University Medical Center which has proved satisfactory in over 150 patients. It has been demonstrated repeatedly to be free of the serious and often lethal intraoperative and postoperative complications previously associated with this procedure.