A 88-year-old man who underwent abdominoperineal resection for rectal cancer 40 years earlier. The patient visited our hospital because of abdominal pain and vomiting. An abdominal CT scan showed an abdominal incisional hernia with a 23×15mm orifice in the midline of lower abdomen. The patient diagnosed with severe aortic valve stenosis on echocardiography. We performed elective surgery under intravenous anesthesia using ketamine and local anesthesia. The patient was discharged on postoperative day 8, and the postoperative course was uneventful. No recurrence has occurred 16 months after the operation. In conclusion, our strategy for patient with severe aortic valve stenosis is safe and effective.