# First Experience With the Triolifter, a Novel Device for Organ Fixation Used as a Heart Positioner in Cardiac Surgery

## TL;DR

This paper introduces the Triolifter, a new and affordable device used in heart surgery to help position the heart during procedures.

## Contribution

The paper presents the first clinical use of the Triolifter as a heart positioner in cardiac surgery.

## Key findings

- The Triolifter was effectively used to expose and control bleeding at anastomosis sites during on-pump beating heart surgery.
- The device caused no significant subepicardial hematoma or epicardial injury.
- The Triolifter is inexpensive and could be used globally in on-pump CABG procedures.

## Abstract

We describe our first experience with the Triolifter (Fuji Systems, Yokohama, Japan) in cardiac surgery. The Triolifter is a less expensive, novel organ fixation device developed as a fixation indenter mainly for traction of the lung under video-assisted surgery and is now available in Japan.

An 84-year-old man diagnosed with unstable angina pectoris underwent emergency coronary artery bypass grafting (CABG) under cardiac arrest. Following the declamping of the aorta and the resumption of the beating heart, bleeding from the left anterior descending artery (LAD) anastomosis site was observed. The Triolifter was used as a heart positioner to expose the anastomosis site for hemostasis in the setting of an on-pump beating heart. Hemostasis of the posterior descending artery (PDA) anastomosis site could also be confirmed by traction of the right ventricular anterior wall using the Triolifter. It could be effectively and safely used with neither significant subepicardial hematoma nor epicardial injury.

In Japan, the Triolifter might be used as one of the insurance-covered devices in off-pump CABG in the future, but globally, it could also be used in on-pump CABG without hesitation because it is so inexpensive.