[Cardiac Surgery in a Patient with a Retrosternal Gastric Tube Reconstruction After Esophagectomy:Report of a Case].

Abstract

Cardiac surgery after retrosternal gastric tube reconstruction presents significant technical challenges because of interference with the median sternotomy approach. We report a 67-year-old man who successfully underwent aortic valve replacement and mitral valve repair a year after subtotal esophagectomy with retrosternal gastric tube reconstruction for esophageal cancer. The gastric tube was carefully mobilized using a combined laparoscopic and cervical approach, allowing safe median sternotomy without injury to the right gastroepiploic artery. Both valve procedures were completed successfully under cardiopulmonary bypass. The patient resumed oral intake on postoperative day 4 and was transferred for rehabilitation on day 15. This case illustrates that with elaborate preoperative planning and careful intraoperative management, complex cardiac surgery can be performed safely even after retrosternal gastric tube reconstruction.