[MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT: CURRENT STATUS AND FUTURE PERSPECTIVES].

The first description of aortic valve replacement (AVR) as minimally invasive cardiac surgery (MICS) was given by Rao et al. in 1993. Recently, the number of MICS-AVR has increased and this procedure has been established as the routine standard operative technique in some institutes. MICS-AVR can be performed with two different approaches. One is an upper partial sternotomy and the other is a right small anterior minithoracotomy. MICS-AVR via upper partial sternotomy can be performed without any special instruments and the technical hurdles are relatively few, but the cosmetic benefit is limited. MICS-AVR via right anterior minithoracotomy offers maximal cosmetic benefit, but the technical hurdles are fairly high. For MICS-AVR, longer aortic clamping time and cardiopulmonary bypass time are needed, but this disadvantage can be overcome with sutureless aortic valve repair, and therefore this procedure may become a standard open surgical procedure in the era of transcatheter aortic valve implantation.