We describe the use of the Starfish 2 heart positioning device as an aid to pericardium reconstruction after en bloc resection of mediastinal tumors of the left pericardium by use of median sternotomy with anterolateral thoracotomy. The Starfish device, which is a tool for off-pump coronary artery procedures, allows excellent cardiac positioning and hemodynamic stability during pericardium reconstruction through a median sternotomy with anterolateral thoracotomy.
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