الفهرس 
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Abstract
Background & 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 re-operation, less post-operative 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.
Methodology: Fifty patients with aortic valve disease randomized into two equal groups; group “A” underwent aortic valve surgery through a minimally invasive right mini-sternotomy . group “B” underwent aortic valve surgery through right anterior thoracotomy. The Pain was evaluated on first, second and fifth day post-operatively. Echo-cardiographic data were performed pre-operatively and at the 3rd month after discharge in all patients. Aortic and single venous canulation double stage with antegrade blood cardioplegia was adopted in group“A”, while in group “B” femoral arterial and venous cannulation was adopted with antegrade blood cardioplegia.
Results: There was no statistical difference between the two groups pre-operatively regarding their age, sex, NYHA class, EF% and spirometric study. There was one case of mortality in mini-sternotomy group .Few post-operative complications occurred in both groups. Total hospital stay, ICU stay, post-operative bleeding, inotropic requirement, ventilatory support, blood transfusion was less in group “B” mini-thoracotomy group, with better cosmetic appearance, more cost effective.
Conclusions: Right mini-thoracotomy minimally invasive technique for aortic valve replacement provides excellent exposure of the aortic valve and offers a better cosmetic scar. In addition, minimally invasive right mini-thoracotomy is as safe as mini-sternotomy for aortic valve surgery, with fewer complications and post-operative pain, less ICU and hospital stay, fast recovery to work with limited movement restriction after surgery. However using mini-sternotomy approach decrease CBP time.