Complete type of thoracic ectopia cordis was diagnosed with prenatal ultrasound study. Just after birth of female baby with 2,750 g body weight, a silastic mesh was selected for covering the heart because of no space for putting the heart into the mediastinum. Protrusion of the liver towards the mediastinum was one of main causes of lifting the heart outside the chest wall. The baby died 7 days after her birth due to heart failure. Soft silastic mesh was not good enough to sustain the ectopic heart constantly and caused paradoxical respiratory movement of mediastinal side of the lung. It is concluded that hard shell coverage of the extremely ectopic heart is necessary to sustain it constantly and to prevent paradoxical respiratory movement of mediastinal side of the lung.