Cardiac Luxation to Facilitate Off-Pump Bilateral Lung Transplantation

To facilitate access to the left hilum during off-pump bilateral lung transplantation we used the Xpose 4™ apical suction device (Guidant Corp., Indianapolis, IN), an off-pump coronary bypass device to luxate the heart out of the pericardium. The effects on circulation and possible myocardial injury were studied in retrospect. We found the device to provide us with an elegant and nondamaging method to visualize the left hilum.