Aortic Valve Replacement and Ascending Aortic Plication in a Postpneumonectomy Patient: Surgical and Perioperative Challenges

Cardiac surgery in postpneumonectomy patients presents unique challenges resulting from altered anatomy and compromised pulmonary function. We report the case of a 56-year-old man with a history of left pneumonectomy for squamous cell carcinoma who underwent an aortic valve replacement and ascending aortic plication for bicuspid aortic valve stenosis and aneurysm. Preoperative planning, including extracorporeal membrane oxygenation readiness, was critical. Median sternotomy with femoral cannulation was performed, with an uneventful recovery, highlighting the importance of meticulous perioperative planning and multidisciplinary approach in optimizing outcomes.