Okiljevic, Bogdan (57193093252)Bogdan (57193093252)OkiljevicRaickovic, Tatjana (57217308817)Tatjana (57217308817)RaickovicZivkovic, Igor (57192104502)Igor (57192104502)ZivkovicVukovic, Petar (35584122100)Petar (35584122100)VukovicMilicic, Miroslav (22934854000)Miroslav (22934854000)MilicicStojanovic, Ivan (55014093700)Ivan (55014093700)StojanovicMilacic, Petar (24832086700)Petar (24832086700)MilacicMicovic, Slobodan (25929461500)Slobodan (25929461500)Micovic2025-06-122025-06-122024https://doi.org/10.3389/fcvm.2024.1369204https://www.scopus.com/inward/record.uri?eid=2-s2.0-85208609703&doi=10.3389%2ffcvm.2024.1369204&partnerID=40&md5=38e64e8e807082c00a71bec3c89f54dfhttps://remedy.med.bg.ac.rs/handle/123456789/1327Background: Our study aimed to evaluate the early outcomes of aortic valve replacement with Perceval S sutureless valve through the right anterior thoracotomy and upper hemisternotomy approaches, and to determine if there are any differences between these two approaches. Methods: We carried out a study using data from 174 patients who underwent minimally invasive Perceval S valve implantation for aortic valve stenosis between January 2018 and August 2023. This was a retrospective, single-center observational study. The patients were divided into two groups: the hemisternotomy group (n = 100) and the right anterior thoracotomy group (n = 74). Results: The overall in-hospital mortality was 1,7%. The cardiopulmonary bypass and cross-clamp times were longer in the right anterior thoracotomy group (p <.001). There were no statistically significant differences in terms of stroke, paravalvular leak, mechanical ventilation time, blood transfusion requirements, pacemaker implantation, reexploration for bleeding, conversion, wound infection, or in-hospital stay. Postoperative chest drainage was lower (p <.001) and postoperative atrial fibrillation occurred less frequently (p =.044) in the right anterior thoracotomy group. The median intensive care unit stay was shorter in the right anterior thoracotomy group (p =.018). Conclusion: Aortic valve replacement with the Perceval S valve through either an upper hemisternotomy or a right anterior thoracotomy is a procedure associated with low perioperative complication rates. Right anterior thoracotomy for an aortic valve replacement with the Perceval S valve was associated with lower postoperative bleeding, a lower postoperative atrial fibrillation incidence and a shorter intensive care unit stay compared to upper hemistornotomy. 2024 Okiljevic, Raickovic, Zivkovic, Vukovic, Milicic, Stojanovic, Milacic and Micovic.aortic valve replacementhemisternotomyminimally invasivesutureless valvethoracotomy