Single-Center Experience With Minimally Invasive Approaches From Sternotomy to Thoracoscopy: Assessing the Learning Curve and Benefits

Background Cardiac surgery is increasingly shifting from traditional full sternotomy (FS) towards minimally invasive cardiac surgery (MICS), driven by evidence of benefits like reduced trauma, faster recovery, and shorter hospital stays. However, the adoption of MICS is hindered by a significant learning curve, technical complexity, and the need for specialized team training and equipment. This study aimed to evaluate the initial outcomes and safety of a newly established MICS program by comparing its first cases with concurrent FS procedures. Results A single-center prospective cohort study was conducted from November 2024 to April 2025, including 98 patients undergoing primary, elective single-valve surgery. Patients were allocated to either the MICS group (n=30), representing the program's initial experience, or the FS group (n=68). The FS group, which had a higher preoperative risk profile and more complex procedures, served as the control. The MICS group demonstrated significantly longer operative and cardiopulmonary bypass times (6.56 vs. 4.87 hours; 122.93 vs. 92.66 minutes, p