Introduction: Minimally invasive aortic valve replacement is becoming a standard treatment. The possibility of extending this approach to more demanding aortic root pathologies is being debated with limited evidence. Attaining comfort in a complex aortic repair is a "dogma" that should always be achieved. Perhaps, the patient's condition, the aortic anatomy and the expertise creates the fundamental principles that achieve stable results over time.
Evidence acquisition: Selection of literature articles was performed using PubMed databases from inception to July 2020. We excluded editorials and expert opinions, review articles, congenital heart disease, and other types of valve repair. According to the limited studies available, case reports were included.
Evidence synthesis: We identified 7 studies from 2015 to 2020 with the number of patients spanning 1 to 117 from single centers' experiences. Three were case reports with aortic repair of a bicuspid aortic valve. A total of 259 mini-AVr patients were analyzed.
Conclusions: In this review article, we sought to analyze and report the experience and results of a currently available series on aortic valve repair (with or without associated aortic root procedures) using mini sternotomy. Early- and long-term data will be reported and discussed in terms of survival and aortic valve function.