Designed to securely lift the heart during off-pump bypass surgery and to easily position and access target vessels while maintaining hemodynamic stability.
The XPOSE 4 Positioner is a 4th generation access device designed to securely lift the heart during off-pump bypass surgery, and to easily position and access target vessels while maintaining hemodynamic stability. Intended for both apical and non-apical placement on the heart, this device provides exceptional maneuverability, greater access, and ease of use. The XPOSE 4 Positioner has a universal type mount.
Combine the XPOSE 4 Access Device with an ACROBAT Stabilizer and you have the ability to reach all major vessels of the heart with a low-profile system that is easy to use for revascularization procedures performed off-pump.
- Active Suspension Technology – Four-degrees-of-freedom suspension design allows normal cardiac motion and maintains stable hemodynamics
- FlexLink Technology >Interlocking links designed for maximum maneuverability and flexibility
- Low-Profile Arm - Refined design for increased operative field exposure
- Compliant Suction Cup - Designed to maintain secure contact with the epicardial surface at a low-vacuum setting
- QuickLock Knob - Single knob with minimal turns for quick locking
- Universal Mount – fits most types of sternal retractors
Clampless Beating Heart Surgery
When a patient is diagnosed with coronary artery disease, a surgeon can perform an operation to restore healthy blood flow to the heart. In this procedure, one or more healthy blood vessels will be taken from the arm, leg or chest and are used to create “new” vessels for the heart. The surgeon will connect or graft one end of the harvested vessel to the aorta that supplies the blood to the heart; the other end will be attached at the surface of the heart, bypassing the blocked portion of the coronary artery. It is not uncommon for a surgeon to perform three or four of these grafts during one operation.
Today many people that have medical conditions such as diabetes, history of stroke, or poor physical health can undergo cardiac surgery with a clampless approach which may lower their risk for developing complications. In contrast to conventional bypass surgery, which stops the heart and puts the patient on a heart-lung machine during the grafting procedure, clampless beating heart bypass surgery uses local stabilization of the heart that allows the surgeon to sew the bypass graft while the heart still beats.
The potential benefits of beating heart surgery may include1:
- Less trauma to the body, since the heart-lung machine is not used
- Fewer cognitive and neurological effects (for example, a stroke)
- Less risk of problems with memory
- Faster recovery rates
- Shorter hospital stays
- Fewer blood transfusions needed
Instructions for Use
Prior to use please see the complete 'Directions for Use' for more information on Indications, Contraindications, Warnings, Precautions, Adverse Events and Operator's Instructions. Caution: Federal (USA) law restricts this device to sale by or on the order of a physician.
The XPOSE 4 Device is intended to expose coronary arteries during minimally invasive, off-pump cardiac surgery through a sternotomy incision approach with a Maquet Stabilization System.
Do not engage the XPOSE 4 Device over a coronary artery, newly infarcted or aneurysmal tissue. If hemodynamic instability is experienced, gently return the heart to its resting position.
Warnings and Precautions
Physicians should be properly trained to perform cardiac surgical procedures with Maquet instruments prior to use. Many variables, including patient anatomy, pathology, and surgical techniques, may influence procedural outcomes. Patient and procedure selection is a responsibility of the medical professional. Care should be taken to ensure that mount and mount lever are clear of tissue when device is positioned on sternal retractor.
 Puskas J, Cheng D, Knight J, et al. Off-pump versus conventional coronary artery bypass grafting. A meta-analysis and consensus statement from the 2004 ISMICS Consensus Conference. Innovations. 2005; 1:3-27