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Figure 3b.  Drawings show use of lateral decubitus positioning for the parasternal approach. M = mass, ST = sternum. (a) When the patient is in the supine position, aerated lung tissue is interposed between the mass and the chest wall. (b) When the patient is placed in the left lateral decubitus position, the mediastinum shifts to the left, creating a direct mediastinal window for needle placement.







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