{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:50:02Z","timestamp":1785801002680,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Right anterior thoracotomy (RAT-AVR) has been the sole established sternum-sparing technique for minimally invasive aortic valve replacement (MICS-AVR) thus far. Nevertheless, transaxillary access, known as Minimally Invasive Cardiac LATeral Surgery (MICLATS-AVR), represents the latest and innovative advancement in sternum-sparing MICS-AVR access routes. In this study, procedural and clinical outcomes of a substantial transaxillary MICS-AVR cohort are compared to those of a RAT-AVR control group; (2) Patients and Methods: This retrospective study included 918 consecutive patients who underwent MICS-AVR at our facility between 2014 and 2022. This cohort was divided into two surgical access-related groups: RAT-AVR (n = 492) and MICLATS-AVR (n = 426). Procedural data, operative morbidity, and mortality were compared between groups. Further analysis was performed using propensity score matching; (3) Results: After matching, 359 pairs of patients were included and analyzed. There were no notable differences observed between the two groups regarding major adverse cardio-cerebral events. Despite longer cardiopulmonary bypass time in the MICLATS-AVR group (63.1 \u00b1 20.4 min vs. 66.4 \u00b1 18.2 min; p \u2264 0.001) the skin-to-skin time (129.4 \u00b1 35.9 min. vs. 126.5 \u00b1 29.8 min.; p = 0.790) and the aortic cross-clamp time was comparable between both groups (41.9 \u00b1 13.3 min. vs. 43.5 \u00b1 14.4 min.; p = 0.182). The overall hospital stay was significantly shorter in the MICLATS-AVR cohort (9.7 \u00b1 5.2 days vs. 9.2 \u00b1 4.5 days; p = 0.01). Both groups were comparable in terms of postoperative morbidities. However, significantly lower rates of postoperative impaired wound healing were noted in the MICLATS-AVR group (11.7% vs. 3.9%, p &lt; 0.001); (4) Conclusions: In comparing MICLATS-AVR and RAT-AVR, our study found MICLATS-AVR to be at least as safe and time-efficient as RAT-AVR, with no significant differences in MACCE. MICLATS-AVR showed a shorter hospital stay and lower postoperative wound issues, indicating its feasibility and safety as an alternative. Notably, MICLATS-AVR is sternum- and bone-sparing, preserving the right mammary artery, and facilitates combined procedures like multiple valve surgeries.<\/jats:p>","DOI":"10.3390\/jcm13040985","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T09:04:01Z","timestamp":1707469441000},"page":"985","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Right Anterior versus Right Transaxillary Access for Minimally Invasive Aortic Valve Replacement: A Propensity Matched Competitive Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0678-7409","authenticated-orcid":false,"given":"Ali","family":"Taghizadeh-Waghefi","sequence":"first","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Arzt","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6827-2489","authenticated-orcid":false,"given":"Asen","family":"Petrov","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3382-1142","authenticated-orcid":false,"given":"Manuel","family":"Wilbring","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Matschke","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utz","family":"Kappert","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Alexiou","sequence":"additional","affiliation":[{"name":"Medical Faculty \u201cCarl Gustav Carus\u201d, TU Dresden, 01307 Dresden, Germany"},{"name":"Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1016\/S0140-6736(15)60308-7","article-title":"5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (partner 1): A randomised controlled trial","volume":"385","author":"Mack","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1056\/NEJMoa1514616","article-title":"Transcatheter or surgical aortic-valve replacement in intermediate-risk patients","volume":"374","author":"Leon","year":"2016","journal-title":"N. 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