Right parasternal approach for aortic valve replacement after retrosternal gastropexy

Aortic valve replacement had to be performed in a 77-year-old man with a history of esophageal carcinoma, which had been treated with two-staged esophageal resection and retrosternal gastropexy. Barium swallowing confirmed the retrosternal course of the stomach, which crossed the midline from the right upper abdomen to the left-sided neck anastomosis. Aortic valve replacement with a bioprosthesis was performed through a small right parasternal thoracotomy. The postoperative course was uneventful. We found that the right parasternal incision is an excellent surgical approach for aortic valve replacement in patients after retrosternal gastropexy.