RE-DO HEART SURGERY, XIPHOID ENTRY
/ SUBXIPHOID PERICARDIAL PROCEDURE

• Remove the standard IMA rake plate from the Snap Clip and replace with a Xiphoid rake.
• Attach an Extender Bar to the end of the Upper Post and mount the ratchet assembly.
• With the Snap Clip and Extender Bar, the unique lifting design of the Rultract® ratchet system may be used with a variety of rakes for various procedures.

For open heart reoperations, the incision is longer than usual at the distal end. Therefore, dissection is started under the xiphoid process.

When a 1" to 1 and 1/2" dissection is achieved, a wide blade attached to the Rultract® Retractor is inserted and the chest pulled up, creating a tunnel under the sternum towards the neck.

The dissection is made with a Bovie extender blade along with a hard plastic suction tip which is used to push the heart down from the chest wall.

After the tunnel is complete, the wires are cut and removed. A sternotomy is then done with a sternal saw.

Robert W. Stewart M.D.
University Hospitals of Cleveland
Note: See Products Page for details.

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