Yale School of Management Dean Sharon Oster leads a business case discussion on CardioThoracic Systems, part of the Yale course Capitalism: Success, Crisis and Reform. She walks through the barriers facing the medical device firm, including competition from rival procedures and companies, so called gatekeeper problems, and the difficulty of understanding what hospital and physician customers actually need. Oster identifies the different players involved in adopting the technology, from surgeons to hospital administrators to insurers, and maps their competing interests and strategies. The lecture works through interest misalignments, information asymmetries, and value discrepancies among these players before closing with a case summary. Recorded in Fall 2009 as part of Open Yale Courses, the session runs 46 minutes and uses the CardioThoracic case to teach how business strategy analysis applies to a real medical technology venture.