Background: Emergency re-sternotomy after cardiac surgery is a rare but high-stakes event that requires rapid, organized intervention, yet standardized cart designs to facilitate this process are lacking.
Methods: A simplified, numerically organized emergency re-sternotomy cart was developed on the basis of multidisciplinary stakeholder input and evaluated through simulation comparing it with the existing cart design.
Results: Simulation results demonstrated improved user satisfaction and a reduction in time to sternal retractor placement-from 280 seconds with the original cart to 57 seconds with the new cart.
Conclusions: This user-friendly and cost-effective emergency re-sternotomy cart design offers a reproducible framework that may enhance efficiency and promote national standardization for emergency re-sternotomies.
Copyright © 2026 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.