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Objectives: Right mini-thoracotomy aortic valve replacement with a sutureless bioprosthesis has become our preferred approach for patients with aortic valve disease. However, the number of cases needed to gain proficiency with this procedure is unknown. The aim of this study is to assess the learning curve for the implantation of the Perceval S sutureless valve via right minithoracotomy. Methods: We performed a retrospective analysis of the first 135 consecutive patients (age 73±11 years; EuroSCORE 6±8) who underwent Perceval S sutureless valve implantation through a right minithoracotomy at our institution between 2011 and 2013. Patients were divided into tertiles (45 patients each) based on sequence. In addition, control charts (CUSUM analysis) were used to monitor the learning curve. Results: No in-hospital mortality was observed. No patients required a conversion to sternotomy. The overall incidence …