Complications involving sternotomy, resternotomy, and canulation procedures include uncontrolled hemorrhage, cardiac arrhythmias, and sternal fracture. Operative complications with first time sternotomy are rare; however, innominate vein injury at first time sternotomy was recently reported. Resternotomy is clearly more difficult owing to adhesions, extant hemodynamic considerations that require reoperation, and cavitary proximity to camouflaged dissection planes. Complications related to the inferior caval vein, left ventricular vent placement, and initiation of cardiopulmonary bypass are also reviewed. This chapter presents some techniques to overcome these obstacles that have been used by the editors and have been associated with excellent results and a minimal rate of unwanted cavitary reentry.