Prior to operating on the heart, the vet will have to sedate the dog with a general anesthetic (usually delivered in the form of gas). The dog will then have a patch on its chest shaved and disinfected in order to provide a clean environment for the vet to operate in. Next, the vet will make an incision through the skin and tissues of the chest just above the breastbone, exposing the sternum and allowing them to easily cut through using a saw to reveal the heart beneath. Once the heart is exposed, the surgeon will cut through the membranes surrounding it in order to reach the auricle. The heart will then be connected to a heart-bypass machine, which will circulate the blood whilst the animal is in surgery. The dog will then have the diseased tissue cut out of the auricle and the remaining pieces attached back together, allowing the heart to be re-connected to the blood supply. Next, the surgeon will suture the dog's wounds shut, using wires or screws to fix the sternum back in place. In most cases, the procedure will take a couple of hours to complete due to the many steps involved.