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Abstract
Backgrpund and objectives : Minimally invasive aortic valve surgery has evolved into a well-tolerated, efficient surgical treatment option in experienced centers, providing greater patient satisfaction and lower complication rates. Potential advantages of minimally invasive aortic valve replacement (MIAVR) arise from the concept that patient morbidity and potential mortality could be reduced without compromising the excellent results of the conventional procedure which include improved cosmetic results, safer access in the case of reoperation, less postoperative bleeding, fewer blood transfusions, lower intensive care unit and in-hospital stays, as well as the absence of sternal wound infection. These results were achievable also in high-risk patients. Reduced pain and hospital length of stay, decreased time until return to full activity, and decreased blood product use have also been demonstrated. Results: There was no statistical difference between the two groups preoperatively regarding their age, sex, NYHA class, EF%, LA dimension, spirometric study. There was no operative mortality in both groups but few postoperative complications occurred in both groups. Total hospital stay, ICU stay, postoperative bleeding, inotropic requirement, ventilatory support, blood transfusion was less in group 2A3, with better cosmetic appearance, more cost effective. Conclusions: limited upper sternotomy minimally invasive technique for aortic valve replacement provides excellent exposure of the aortic valve and offers a better cosmetic scar. In addition, minimally invasive limited upper sternotomy is as safe as full median sternotomy for aortic valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with limited movement restriction after surgery. It is better to use the limited upper sternotomy incision as an initial approach for aortic valve surgery