title: Minimally invasive aortic valve replacement using right minithoracotomy is associated with better outcomes than ministernotomy.
abstract: 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.
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy. Electronic address: antoniomiceli79@alice.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Miceli
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Murzi
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Danyiar
authors.initials: D
authors.lastname: Gilmanov
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Fugà
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrarini
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Solinas
authors.affiliation: Cardiothoracic Department, Fondazione Toscana G. Monasterio, Massa, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Glauber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome