Longitudinal median sternotomy is even nowadays the standard approach to operations of the aortal valve. The authors summarize in the submitted paper their experience with operations in 60 patients where replacement of the aortal valve was performed either from a small transverse sternotomy in the second intercostal space or from upper ministernotomy from the jugulum to the fourth (third) intercostal space. One patient died. The low incidence of serious postoperative complications, the rapid rehabilitation of patients and short subsequent period of hospitalization indicate the advantateges of this approach. The authors use at present upper ministernotomy as the surgical approach in the majority of operations of the aortal valve.

        Key words: RCHS - aortal valve - surgical treatment - minimal invasive approach