The increasing number of coronary operations performed on a beating heart has prompted the development of new techniques and instruments to expose the coronary arteries without major hemodynamic derangements. We describe an expandable surgical pad combined with a series of tapes that help to control rotations and positioning of the heart. The empty surgical pad is fixed at the bottom of the pericardial cavity. After injection of warm saline, the pad elevates and displaces the heart, and the tapes rotate and immobilize the heart in the desired position. Easy access to all coronary arteries with minimal effect on hemodynamics is possible.