It is ironic that John Gibbon's interest in the development of CPB was stimulated by his experience with a fatal case of pulmonary embolism. Massive pulmonary embolism is a siginificant cause of death in hospital, despite improvement in patient management in recent years. In Korea, none of the reports was detailed the anesthetic management of this group of physiologically compromised patients. So we describe an approach to the anesthetic management of a patients with chronic embolic occlusion of the pulmonary artery, who underwent successful pulmonary embolectomy.