**4.2 Postoperative bleeding**

The incidence of re-exploration due to excessive bleeding ranges from 3.8% up to 12% [15–18]. The latter high number was reported by Semsroth et al. in a subgroup of 167 patients who were operated through an ART. One explanation could be that they already experienced lots of issues with intraoperative bleeding, which resulted in the fact that bleeding was the predominant cause for conversion to median sternotomy [18]. Most often significant bleeding occurs on the aortotomy edges, on cannulation sites, especially the right superior pulmonary vein, on sternotomy edges or if the RITA is injured.
