Surgery Without Visible Scars: The Right Lateral Access for Minimally Invasive Aortic Valve Surgery

In times of expanding indications for transcatheter aortic valve replacement—justified or not—consistent implementation of minimally invasive strategies is needed to meet patients’ growing demands for improved quality of life and quicker postprocedural recovery. The main access routes for minimally invasive aortic valve surgeries do have their particular limitations, eg, sternal instability, lung herniation, rib luxation, or impaired wound healing induced by the loss of the right mammary artery. In this video, the authors present a more lateral access: a 5 cm skin incision in the right anterior axillary line using the third or fourth intercostal space. The technique is safe and reproducible, leaving the sternum and the ribs completely untouched and finally providing a superior cosmetic result with nearly no visible scars.