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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