The Innovation of an Expert-Guided Emergency Re-Sternotomy Cart: A Narrative Review.

O'Brien, Devin; White, Abigail; Jensen-Holubowich, Sydney; Salvador, Maricon; Nagendran, Jayan; Moon, Michael; White, Christopher W · Ann Thorac Surg · 2026

review · Level V

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Abstract

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. 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. 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. 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.

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