Long-Term Outcomes after Minimally Invasive Aortic Valve Surgery through Right Anterior Minithoracotomy.

 Minimally invasive aortic valve surgery (MIAV) through a right anterior minithoracotomy evolved to an accepted procedure with favorable short- and mid-term outcomes, whereas long-term results lack. The aim of this study was to evaluate the long-term outcomes.  All our MIAV patients were included ( = 225). Mean age was 68 ± 12 years, 29% were older than 75 years, and median EuroSCORE was 5 (0-11). Baseline characteristics, inhospital outcomes, and follow-up information about survival, major adverse cardiac and cerebrovascular events (MACCE), and need for reoperation were collected and analyzed.  In this study, 30-day mortality was 1.3%, and there was no permanent stroke. Mean follow-up time was 69.65 ± 24 months, being the longest so far reported in the literature. At 1 and 7 years, survival was 95.8 and 79%, freedom from MACCE 98.1 and 95.7%, and from reoperation 99.5 and 98.7%, respectively.  MIAV is safe and feasible with favorable long-term outcomes. In the future, it could serve as benchmark for interventional methods as soon as indications are expanded to young and low-risk patients. Randomized studies are needed to compare the long-term outcomes of these approaches.