{"title":"Cardiothoracic Instruments","description":"\u003cp\u003eInstruments for cardiac, thoracic and vascular surgery: atraumatic occlusion and cross clamps in the Diethrich, Satinsky, DeBakey, Cooley, Glover, Gregory, Derra and Wylie patterns, Finochietto rib spreaders from newborn to adult, Giertz and Giertz-Stille rib shears, sternum shears, Rumel tourniquets and ligature clamps, and angled vascular scissors.\u003c\/p\u003e\u003cp\u003eThe Diethrich range runs deepest - micro coronary bulldogs in 8mm and 12mm straight and angled jaws, aortic clamps, needle holders, and coronary artery scissors at 25°, 45°, 60° and 90°.\u003c\/p\u003e\u003ch2\u003eWhy a cardiac clamp is not a heavy haemostat\u003c\/h2\u003e\u003cp\u003eThis is the distinction that matters most on this page, and it is the one most often got wrong when substituting instruments.\u003c\/p\u003e\u003cp\u003eA haemostat closes a vessel by \u003cstrong\u003ecrushing\u003c\/strong\u003e it. Its jaw serrations run transverse to the jaw - across it - and they are there to stop tissue sliding out. That is correct for a vessel you are about to tie off and never use again.\u003c\/p\u003e\u003cp\u003eA vascular clamp has to do something harder: \u003cstrong\u003eocclude flow completely, then let the vessel work normally afterwards.\u003c\/strong\u003e The failure mode is not bleeding, it is \u003cem\u003eintimal injury\u003c\/em\u003e. The intima is the single-cell layer lining the vessel, and where it is damaged, platelets aggregate. A crush line across an aorta or a coronary is where a thrombus forms days later, or where a dissection starts.\u003c\/p\u003e\u003cp\u003eThat is why atraumatic jaws - the DeBakey pattern - carry fine \u003cstrong\u003elongitudinal\u003c\/strong\u003e rows of teeth that interdigitate rather than meet. They hold the wall closed along its length without pinching it at any single line. It is also why these clamps cost more than a haemostat of the same size and why the substitution is a false economy.\u003c\/p\u003e\u003ch2\u003eTangential or cross clamp?\u003c\/h2\u003e\u003cp\u003eBoth appear on this page and they do opposite things.\u003c\/p\u003e\u003cp\u003eA \u003cstrong\u003ecross clamp\u003c\/strong\u003e occludes the vessel completely. Nothing flows past it. That is what you want for an aortic anastomosis, and it is why cross-clamp time is a number cardiac teams watch so closely.\u003c\/p\u003e\u003cp\u003eA \u003cstrong\u003etangential occlusion clamp\u003c\/strong\u003e - the Satinsky and DeBakey-Satinsky patterns - takes a bite out of the \u003cem\u003eside\u003c\/em\u003e of the vessel. The clamped portion is isolated for suturing while blood continues through the remaining lumen. That is what makes a partial-occlusion anastomosis possible without arresting circulation, and it is the reason the Satinsky jaw carries its distinctive long curve: the curve is what lets the jaw sit across a chord of the vessel rather than its full diameter.\u003c\/p\u003e\u003cp\u003eChoosing a cross clamp where a tangential one was wanted does not just complicate the repair - it changes whether circulation stops.\u003c\/p\u003e\u003ch2\u003eSizing a Finochietto rib spreader\u003c\/h2\u003e\u003cp\u003eThe figures in these titles are the \u003cstrong\u003eblade dimensions and maximum spread\u003c\/strong\u003e, not a model number: 15×15×75mm for newborn, 34×42×135mm pediatric, up to 65×85×250mm for an adult chest.\u003c\/p\u003e\u003cp\u003eSize is decided by the patient, not by preference. A spreader whose blades are too large for the intercostal space concentrates force on two ribs instead of distributing it, and \u003cstrong\u003erib fracture during exposure\u003c\/strong\u003e is the result - most often in the elderly and in children, the two groups least able to tolerate it. Erring larger is not the safe direction here.\u003c\/p\u003e\u003ch2\u003eAluminium or stainless?\u003c\/h2\u003e\u003cp\u003eSeveral Finochietto patterns are stocked in both, and the trade-off is real.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eAluminium\u003c\/strong\u003e is markedly lighter. On a retractor that sits in an open chest for several hours, that weight is transmitted to the patient's chest wall the whole time, and it is also weight the scrub team handles repeatedly.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eStainless\u003c\/strong\u003e is heavier but harder. It resists the thread wear and rack deformation that eventually loosen a spreader's hold, and it tolerates more reprocessing cycles before the ratchet starts slipping.\u003c\/p\u003e\u003cp\u003eA spreader that slips mid-case is worse than a heavy one, so high-volume theatres tend to stainless and lower-volume ones to aluminium.\u003c\/p\u003e\u003ch2\u003eFrequently asked\u003c\/h2\u003e\u003cp\u003e\u003cstrong\u003eAre the bulldog clamps spring or ratchet?\u003c\/strong\u003e Spring. That is deliberate - a spring delivers a known, repeatable force calibrated to the jaw size, where a ratchet is only as gentle as the hand that set it. See the \u003ca href=\"\/collections\/bulldog-clamps-cardiothoracic\"\u003ebulldog clamps\u003c\/a\u003e page for why that matters on a coronary.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eWhat is the difference between the 25°, 45°, 60° and 90° Diethrich scissors?\u003c\/strong\u003e The angle between blade and shank. A steeper angle lets the blade reach a vessel lying deep or across the working line without the surgeon's hand blocking the view - the whole reason angled coronary scissors exist.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eDo you stock pediatric and neonatal sizes?\u003c\/strong\u003e Yes - the Finochietto range includes newborn and baby spreaders, and several clamp patterns come in pediatric jaw lengths.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eIs a Rumel tourniquet the same as a clamp?\u003c\/strong\u003e No. A Rumel snugger tightens a ligature loop around a vessel or cannula to control flow, and releases it without re-clamping. It is stocked with and without a ratchet, in adult and child sizes.\u003c\/p\u003e\u003ch2\u003eRelated collections\u003c\/h2\u003e\u003cp\u003eSee also \u003ca href=\"\/collections\/bulldog-clamps-cardiothoracic\"\u003eBulldog Clamps\u003c\/a\u003e, \u003ca href=\"\/collections\/clamps\"\u003eSurgical \u0026amp; Vascular Clamps\u003c\/a\u003e, \u003ca href=\"\/collections\/diethrich-instruments\"\u003eDiethrich Instruments\u003c\/a\u003e, \u003ca href=\"\/collections\/rib-spreaders\"\u003eRib Spreaders\u003c\/a\u003e, \u003ca href=\"\/collections\/rib-shears\"\u003eRib Shears\u003c\/a\u003e and \u003ca href=\"\/collections\/super-cut-scissors\"\u003eSuper Cut Scissors\u003c\/a\u003e.\u003c\/p\u003e\u003cp\u003eAlso for thoracic work: \u003ca href=\"\/collections\/raspatories\"\u003eDoyen Rib Raspatories\u003c\/a\u003e, \u003ca href=\"\/collections\/bronchoscopes\"\u003eBronchoscopes\u003c\/a\u003e, \u003ca href=\"\/collections\/needle-holders\"\u003eCardiovascular Needle Holders\u003c\/a\u003e and \u003ca href=\"\/collections\/mallets\"\u003eMallets \u0026amp; Sternal Knife Accessories\u003c\/a\u003e.\u003c\/p\u003e","products":[{"product_id":"glover-clamp-curved-right-angled-long","title":"Glover Clamp curved right angled long","description":"\u003cp\u003eThe \u003cstrong data-start=\"4\" data-end=\"47\"\u003e\"Glover Clamp Curved Right Angled Long\"\u003c\/strong\u003e is a specialized surgical instrument used primarily in vascular or delicate tissue surgeries.\u003c\/p\u003e","brand":"DDP ELITE USA","offers":[{"title":"Default Title","offer_id":49737192636568,"sku":"DEU- R06817","price":303.41,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/products-65-6583_1_5f18bc89-f2df-49de-bc1e-9dd211280412.jpg?v=1787587667"},{"product_id":"glover-multi-purpose-vascular-clamp-17cm","title":"Glover Multi-Purpose Vascular Clamp, 17cm","description":"\u003cp\u003eGlover multi-purpose vascular clamp at 17cm working length for atraumatic occlusion of arteries and veins. 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German surgical-steel construction with reliable ratchet.\u003c\/p\u003e","brand":"DDP ELITE USA","offers":[{"title":"Default Title","offer_id":49737192800408,"sku":"DEU- R06817","price":299.17,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/320-210-J_e3588c2b-ab8f-4cee-8b88-8aff2045f436.jpg?v=1787587671"},{"product_id":"gluck-rib-shear-22cm","title":"Gluck Rib Shear 22cm","description":"\u003cp\u003eGluck rib shear, 22cm. Heavy-duty cutting jaws for rib resection during thoracic procedures. German surgical-steel construction.\u003c\/p\u003e","brand":"DDP ELITE USA","offers":[{"title":"Default Title","offer_id":49737192964248,"sku":"DEU- R06635","price":208.58,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/300-302.jpg?v=1787587673"},{"product_id":"gregory-profunda-clamp","title":"Gregory Profunda Clamp","description":"\u003cp\u003eThe Gregory profunda clamp is a peripheral vascular clamp designed for atraumatic occlusion of the profunda femoris and similar mid-sized vessels. Longitudinal serrated jaws hold the vessel without crushing intima, while the box-lock joint and ratchet shank give controlled, repeatable closure during anastomosis and bypass work.\u003c\/p\u003e\u003cp\u003eAvailable in 13 cm and 16 cm working lengths. German surgical-steel construction, fully autoclavable.\u003c\/p\u003e","brand":"DDP ELITE USA","offers":[{"title":"GREGORY profunda Clamps 16cm","offer_id":49737209774232,"sku":"DEU- R06831","price":402.88,"currency_code":"USD","in_stock":true},{"title":"GREGORY profunda Clamps 13cm","offer_id":49737209807000,"sku":"DEU- R06830","price":402.88,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/9ead4f65d0b53635562867eb775a5c1a.webp?v=1787587825"},{"product_id":"haight-infant-rib-spreader-90x30x30x65mm","title":"Haight Infant Rib Spreader 90x30x30x65mm","description":"\u003cp\u003eHaight infant rib spreader with a 90x30x30x65mm frame for neonatal and infant thoracic exposure. German surgical-steel construction with a rack-and-pinion mechanism for graduated spread and a stable hold on small chest walls. 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By gently separating the ribs, this rib spreader makes it easier to enter the chest cavity and gives surgeons the best visibility and control possible when doing procedures.\u003c\/p\u003e","brand":"DDP ELITE USA","offers":[{"title":"Default Title","offer_id":49737214001304,"sku":"DEU- R06674","price":609.84,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/products-60-1075_1_03fea725-5821-4769-aa40-29ceea2d738c.jpg?v=1787587900"},{"product_id":"jarit-625-141-debakey-lap-forcep","title":"Jarit Debakey Lap Forcep","description":"\u003cdiv class=\"tabcontent\" id=\"description\"\u003e\n\u003cul\u003e\n\u003cli\u003eJarit 625-141 Debakey Lap Forcep\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/div\u003e\u003cdiv id=\"specs\" class=\"tabcontent\"\u003e\n\u003c\/div\u003e","brand":"DDP ELITE USA","offers":[{"title":"Excellent","offer_id":49737276031128,"sku":"DEU-LAPA00502","price":310.5,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/625-141.jpg?v=1787588856"},{"product_id":"jarit-debakey-lap-forcep-10mm-x-33cm-600-145","title":"Jarit Debakey Lap Forcep, 10mm x 33cm","description":"\u003cmeta charset=\"utf-8\"\u003e\u003cul data-mce-fragment=\"1\"\u003e\n\u003cli data-mce-fragment=\"1\"\u003eJarit 600-145 Debakey Lap Forcep\u003c\/li\u003e\n\u003cli data-mce-fragment=\"1\"\u003e10mm x 33cm\u003c\/li\u003e\n\u003c\/ul\u003e","brand":"DDP ELITE USA","offers":[{"title":"Excellent","offer_id":49737276063896,"sku":"DEU-LAPA00503","price":310.5,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0596\/8704\/3224\/files\/600-145.jpg?v=1787588858"},{"product_id":"klinkenberg-loth-vascular-scissors-curved-23cm","title":"Klinkenberg-Loth Vascular Scissors, Curved, 23 cm","description":"\u003cp\u003eKlinkenberg-Loth vascular scissors with curved blades, 23 cm overall length. 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