Abstract:Objective To compare the surgical effect and the incidence of early postoperative complications between right-sided minithoracotomy and conventional median sternotomy in single valve replacement surgery. Methods Thirty patients were selected retrospectively, who received single-valve replacement through right-sided minithoracotomy with closed cardiopulmonary bypass (minimally invasive group) in Nanjing First Hospital from July 2019 to June 2021, and 30 patients undergoing the operation through conventional median sternotomy during the same period were served as controls. The differences in intraoperative and postoperative related indicators and postoperative complications were compared between two groups. Results Compared with those in control group,the cardiopulmonary bypass time ［(123.70 ± 20.19) min vs (89.27 ± 23.40) min, P<0.01］ and aortic cross-clamp time ［(87.47 ± 15.07) min vs (64.27 ± 15.38) min, P<0.01］ were prolonged, and the average stay in ICU was significantly shorter ［21.00 (19.25, 41.00)h vs 39.00 (22.75, 52.25)h, P<0.01］ in minimally invasive group. There was no significant difference in mechanical ventilation time and postoperative hospital stay between two groups (P>0.05).The total incidence of early postoperative complications in minimally invasive group was significantly lower than that in control group （46.67% vs 76.67%，P<0.05）. All patients were discharged successfully, and there was no perioperative death in both groups. 〖Conclusion For the patients with single-valve replacement, the right-sided minithoracotomy has the advantage in the shorter stay in ICU, the lower incidence of early postoperative complications and the better safety compared with the conventional median sternotomy. However, it prolongs the intraoperative cardiopulmonary bypass time and aortic cross-clamp time, which should be improved in the future.