Coronary artery bypass grafting and aortic valve replacement in a patient with a tracheostoma

We report a 67-year-old man with a tracheostoma who successfully underwent coronary artery bypass grafting and aortic valve replacement. He had received both a tracheostoma just above the sternal notch after total laryngectomy. As the standard full sternotomy might cause mediastinitis, we performed the operation through a lower half sternotomy with a limited skin incision. Postoperatively the wound was covered with a sterile plastic drape to prevent infection from the tracheostoma. The postoperative course was uneventful.