Pericardial Window Through Left Antero Lateral Thoracotomy : A small left antero lateral thoracotomy is done through the 5"' intercostal space. A pericardial window is made anterior to the phrenic nerve by exicising a piece of pericardium. This effectively makes a pleuro pericardial window. The chest is closed with a drain in the pleura that will drain the pericardial fluid also.