The impossible airway: a plan.

A patient presented with near complete airway obstruction due to a massive tumor. Nonsurgical methods failed to secure the airway, and surgical approaches were considered unlikely to succeed in a timely fashion. Cardiopulmonary bypass via femoral-femoral cannulation with the use of local anesthesia and a portable unit, followed by IV anesthesia, allowed the surgeons to perform a controlled tracheotomy.