Minimally invasive aortic valve replacement (MIAVR) offers reduced surgical trauma, faster recovery, and shorter hospital stays compared to full sternotomy. However, concerns persist about longer cardiopulmonary bypass (CPB) times and smaller valve sizes due to limited exposure. Evaluating how outcomes change with experience is important to assess MIAVR's safety and broader applicability.

We analyzed trends in MIAVR at a single center over 13 years, comparing early (2011–2016) and later (2017–2024) cohorts. We assessed changes in operative times, valve size selection, and conversion to sternotomy, along with long-term survival. Findings reflect the evolution of MIAVR technique and its impact on outcomes.