Starting out in minimally invasive aortic valve replacement in the UK.

OBJECTIVES Here we aim to describe in detail the logical procedure and philosophical approach to establish a minimally access aortic valve replacement programme in the current era. METHODS A real example of a National Health Service Trust in the United Kingdom has been described in a step-wise manner. RESULTS The outcomes of the new procedure established in this fashion are reported and the philosophical lessons learnt from the experiences are highlighted. CONCLUSIONS It is hoped that this paper will act as a template for newly established surgeons to embark onto a mini-AVR programme. An open-minded and enthusiastic team will undoubtedly be able to facilitate the introduction of this 'new service'. A sensible approach will provide safe and sustainable outcomes.