In 2021 approximately 97,000 Australians had severe aortic stenosis. Each year an estimated additional 9,300 (≥60yrs) will be added. 6,300 will become symptomatic with 3,700 and 1,600 per year potential Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement candidates respectively1. Competing SAVR approaches are Full Sternotomy (FS) or Minimally Invasive Aortic Valve Replacement (MIAVR); primarily via Right Anterior/Axillary Thoracotomy or hemi-sternotomy. Benefits of MIAVR have been established2. It is hoped this series will increase interest in MIAVR amongst Australian and New Zealand surgeons. Isolated SAVR procedures from 1/1/2016 to 1/12/2021 at Prince of Wales (Public and Private) Hospitals, Sydney were included. MIAVR cases were performed via Right Anterior Thoracotomy (RAT)(n=49) and were compared to FS(n=290). We found no pre-operative significant differences (Table 1). Significant intraoperative differences: mechanical valve selection FS 18.6% vs RAT 6.1% (p=0.030), x-clamp time FS 82.3min vs RAT 70.6min (p=0.032) and bypass time FS 113.4min vs RAT 92.6min (p<0.001) (Table 2). Significant post-operative differences: mean ventilation time, FS 28.8hrs vs RAT 17.2hrs (p=0.001), mean drain output/24 hours FS 556.8mL vs RAT 401.1mL (p=0.022), discharge haemoglobin FS 106.3g/L vs RAT 116.7g/L (p=0.004) and mean length of stay FS 12.7 days vs RAT 8.3 days (p=0.006) (Table 3). We believe RAT MIAVR is a beneficial and safe option in select patients requiring SAVR. 1.Strange G et al (2021). Uncovering the treatable burden of severe aortic stenosis in Australia: Current and future projections within an ageing population, BMC Health Services Research, 21(1) doi:10.1186/s12913-021-06843-0 2.Glauber M et al (2013) Right anterior minithoracotomy vs conventional aortic valve replacement: A propensity score matched study, The Journal of Thoracic and Cardiovascular Surgery, 145(5), p1222–1226 doi:10.1016/j.jtcvs.2012.03.064.