The effectiveness of the "open chest" for the unstable patient after bilateral sequential lung transplantation.

Respiratory or hemodynamic instability after lung transplantation is one of the most challenging experiences a lung transplant surgeon and anesthesiologist face. We used an "open chest" approach as a feasible modality for managing these difficult patients. In this single-institution review of patients managed with this technique, we report the criteria for consideration, technical aspects, and overall effectiveness of this peri-operative strategy.