Minimally invasive aortic valve replacement using right minithoracotomy is associated with better outcomes than ministernotomy.

Objective: To compare the outcomes of right minithoracotomy (RT) versus ministernotomy (MS) in patients undergoing minimally invasive aortic valve replacement (AVR).

Methods: From January 2005 to December 2011, 406 patients underwent minimally invasive AVR, of whom 251 patients were in the RT group and 155 were in the MS group.

Results: The overall in-hospital mortality was 1.2% with no difference between the 2 groups (1.2% in RT vs 1.3% in MS). Patients undergoing minimally invasive AVR using RT had a lower incidence of postoperative atrial fibrillation (19.5% vs 34.2%, P = .01), shorter ventilation time (median, 7 vs 8 hours; interquartile range, 5-9 vs 6-12 hours, P = .003), intensive care unit stay (median 1 vs 1 day; interquartile range, 1-1 vs 1-2 days; P = .001), and hospital stay (median, 5 vs 6 days; interquartile range, 5-6 vs 5-8 days; P = .0001). No difference was found in terms of cardiopulmonary time, crossclamping time, postoperative stroke, re-exploration for bleeding, or blood transfusion.

Conclusions: Minimally invasive AVR using RT was associated with lower postoperative morbidities and a shorter hospital stay than MS.