Background: In patients with congenital heart disease, stenosis of major airways or pulmonary vessels between aortic arch occasionally occurs because enlarged heart, arch anomalies, and malposition of ventricular outflow tract. Aortopexy is a surgical procedure that the aortic arch is fixated at other structures and surgical option in patients with the stenosis of structures between aortic arch. We evaluated the outcome of aortopexy in patients with congenital heart disease. Methods: We reviewed clinical data of 26 patients who had the stenosis of main bronchi or pulmonary vessels and were operated aortopexy. In 22 patients, CT was performed for analysis of the region and mechanism of the stenosis. We compared the severity of bronchial stenosis before aortopexy, immediately after operation (< 1 month) and after grown up. The severity of the bronchial stenosis was determined by measuring the diameter ratio between the narrowest bronchus and trachea. To explore the mechanism of compression, we measured as follows in CT: (a) depth of the retrosternal space, (b) the aorto-spinal distance, (c) the interaortic distance, and (d) the sterno-spinal distance. We calculated the interaortic distance index (c/d). The data were analyzed using the SPSS statics 17.0. Results: Totally 26 patients consisted of 14 boys and 12 girls. Their age at the time of aortopexy was from 8 days to 19 years old. Most patients were operated as recurrent URI or impossibility of ventilator weaning. 6 patients had a compressed region in lower trachea, 13 patients in left main bronchus, 2 patients in right main bronchus, and 4 patients in pulmonary vessels. Aortopexy was performed at ascending aorta in 15 patients, at descending aorta in 8 patients, and at transverse arch in 2 patients. CT in follow period is performed in 11 patients immediately after operation (mean 9.82 days) and in 13 patients after grown up (mean 4.81 years). We compared the diameter ratio between the narrowest bronchus and trachea and it significantly increased after aortopexy. (P value 0.016; before aortopexy, 0.18짹0.11 vs immediately after aortopexy, 0.29짹0.12, P value 0.009; before aortopexy 0.26짹0.17 vs after grown up, 0.42짹0.17). The interaortic distance index also increased after aortopexy. (P value 0.026; before aortopexy, 0.28짹0.07 vs immediately after aortopexy, 0.32짹0.09, P value 0.036; before aortopexy, 0.34짹0.09 vs after grown up, 0.39짹0.08). In our study, there were 3 mortality cases as bronchospasm, respiratory failure, and multiple organ failure. Conclusion: Aortopexy in patients who had the compressed structures between arches is useful surgical option. Aortopexy that is suitable for situation of patients must be considered.