Situation
A patient who has previously undergone AVR and CABG x 2 is referred to you for mediastinoscopy for enlarged lymph nodes. What do you do ?
The only important point in the history here is whether a tracheostomy was performed after the cardiac surgery, if not just go ahead (beware of the warfarin), the plane for mediastinoscopy is not entered during cardiac surgery so its just like a first time procedure.