The Department of Veterans Affairs is seeking to procure a Medistim MiraQ Ultimate System, a proprietary cardiac surgical device that combines transit-time flow measurement and high-frequency ultrasound imaging. This system will be used by surgical teams at the VA St. Louis Health Care System to enhance surgical precision and patient outcomes. The Medistim MiraQ Ultimate is the only FDA-cleared system that combines these capabilities, and clinical input confirms the requirement for this specific system. Some key features of this opportunity include: • The system will be used for intraoperative graft assessment and vessel visualization • It is essential for real-time decision-making during cardiac and vascular surgeries • No other product on the market offers this integrated capability • Clinician input at VA St. Louis Health Care System confirms this system is essential for surgical quality and aligns with current workflow