**1. Introduction**

elective coronary artery bypass graft surgery. A randomized, controlled trial. Ann In‐

[89] Lie I, Arnesen H, Sandvik L, Hamilton G, Bunch EH. Effects of a home-based inter‐ vention program on anxiety and depression 6 months after coronary artery bypass

[90] Freedland KE, Skala JA, Carney RM, Rubin EH, Lustman PJ, Dávila-Román VG, et al. Treatment of depression after coronary artery bypass surgery: a randomized control‐

[91] Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, et al. Exer‐ cise treatment for major depression: maintenance of therapeutic benefit at 10 months.

[92] McKenzie LH, Simpson J, Stewart M. A systematic review of pre-operative predic‐ tors of post-operative depression and anxiety in individuals who have undergone

[93] Cserép Z, Losoncz E, Malik A, Székely A, Balog P, Kopp M. Psychosocial factors de‐ termining life expectancy of patients undergoing open heart surgery. Orv Hetil.

[94] Johnston G, Goss JR, Malmgren JA, Spertus JA. Health Status and Social Risk Corre‐ lates of Extended Length of Stay Following CABG Surgery. Ann Thorac Surg.

coronary artery bypass graft surgery. Psychol Health Med. 2010;15:74-93.

grafting: a randomized controlled trial. J Psychosom Res. 2007;62:411-8.

tern Med. 2000;133:253-62.

492 Artery Bypass

led trial. Arch Gen Psychiatry. 2009;66:387-96.

Psychosom Med. 2000;62:633– 8.

2008;149:1549-54.

2004;77:557-62.

Median sternotomy due to its technical simplicity and excellent exposure of the heart, great vessels and pulmonary hila is the most common incision performed in cardiothoracic surgery worldwide [1]. Originally described by Julian more than 100 years ago and re-induced by Milton in 1957, median sternotomy replaced gradually thoracotomy or bilateral transverse sternothoracotomy (clamshell incision) for routine access to the heart [2,3]. Even though median sternotomy is still considered to be the gold standard, efforts remain ongoing to use less invasive methods such as partial sternotomy or small thoracotomy to influence the risk of wound healing complications, patient's satisfaction and better quality of life [4].
