We describe 2 cases of aortic valve stenosis with severe pulmonary dysfunction. Preoperative respiratory rehabilitation programmed by the rehabilitation doctors was cautiously undertaken to improve their exercise tolerance and respiratory reserve. These 2 patients underwent aortic valve replacement eventually. Postoperative course in each patient was uneventful without respiratory complication. Preoperative respiratory rehabilitation can be performed in the high risk patient with severe pulmonary dysfunction as long as careful risk management is guaranteed.