title: A new multisuction cardiac positioner for multivessel off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  : To accomplish successful multivessel off-pump coronary artery bypass grafting, safe, reproducible, and effective exposure of all coronary territories is essential. For this purpose, we developed a new, simple, multisuction cardiac positioner.
  
  
  METHODS
  : This new cardiac positioner consists of 3 small independent suction cups and suction tubes made of silicone. Unlike an apical suction cardiac positioner, this positioner has no arm. The suction cups can be applied with negative pressure of 300 mm Hg to various surfaces of the ventricle, including not only the apex but also the lateral, inferior, and right ventricular walls, according to surgeon preference. We applied this positioner in 15 clinical multivessel off-pump coronary artery bypass procedures.
  
  
  RESULTS
  : In all cases, all target vessels including those on the lateral or inferior wall were successfully exposed and grafted without hemodynamic compromise. Surgical exposure, especially on the lateral and inferior walls, was quite similar to that of conventional coronary artery bypass graft procedures performed during cardiopulmonary bypass.
  
  
  CONCLUSIONS
  : The multisuction cardiac positioner provided reproducible and easy access in multivessel off-pump coronary artery bypass surgery. This simple, variable, and inexpensive cardiac positioner may be used as a new tool to aid in the performance of successful multivessel off-pump coronary artery bypass surgery.
authors.affiliation: From the Department of Cardiothoracic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, Tokyo Japan.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Arai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mizuno
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yoshizaki
authors.forename: Fusahiko
authors.initials: F
authors.lastname: Itoh
authors.forename: Keiji
authors.initials: K
authors.lastname: Oi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Someya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Sunamori