Aortic Valve Replacement after Retrosternal Gastric Tube Reconstruction for Esophageal Cancer

(Department of Surgery‡U, Kochi University, Nankoku, Japan)

Takeshi Iida Hideaki Nishimori Takashi Fukutomi
Seiichiro Wariishi Masaki Yamamoto and Shiro Sasaguri
We present a case of aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer. A 84-year-old man with a history of esophageal resection with retrosternal reconstruction by gastric tube for esophageal cancer required aortic valve replacement for aortic stenosis. The aortic valve was approached through an 8-cm right parasternal incision over the third and fourth costal cartilages. Cardiopulmonary bypass was initiated through cannulas in the ascending aorta and the right atrium and the aortic valve was replaced with a bioprosthetic valve. The postoperative course was uneventful. In the literature, there are only 7 reports on such cases so far, in which aortic valve relplacement was performed through left thoracotomy, right parasternal approach or median sternotomy. We recommend the right parasternal approach in cases of aortic valve replacement in patients with retrosternal gastric tube, because it does not only avoids injury of gastric tube, but also offers an excellent operative view.
@Jpn. J. Cardiovasc. Surg. 37: 329-332 (2008)