Background. Cardiac surgeons increasingly favour the adoption of minimally invasive techniques for patients with aortic disease. Methods. We retrospectively analyzed the clinical data of 41 patients who underwent the Bentall procedure performed by the same surgical team between January 2014 and February 2024. We compared 10 patients who received the minimally invasive Bentall procedure to 31 patients who underwent a conventional median sternotomy. Results. Our operative times are consistent with those documented in the literature: the cardiopulmonary bypass (CPB) duration averaged 170.9 ± 31.62 minutes, and aortic cross-clamping time was 114.8 ± 19.34 minutes for patients with minimally invasive access, compared to 172.36 ± 79.98 and 104.14 ± 31.62 minutes respectively for the patients with standard approach (p = 0.503 and p = 0.194). Mortality in patients with minimal surgical access was one patient or 10%, and with total median sternotomy, it was three or 9.7%, with almost identical results p = 0.976. There was never a re-sternotomy due to bleeding or other reasons, nor a conversion to total sternotomy due to a complication related to the surgical intervention. Conclusion. This report highlights that the increasing demand and preference for more minimally invasive techniques in cardiac surgery can be met by careful patient selection in experienced centres without reducing safety or surgical efficacy, even in more complex cardiovascular pathologies.

Aortic root replacement, Bentall procedure, minimally invasive aortic surgery