Minimally Invasive Aortic Valve Replacement is not just a matter of the incision, but it should be rather considered as a holistic approach to minimize surgical trauma: our technique aims to reproduce the gold-standard conventional procedure in terms of safety, effectiveness and operative time through a small and different incision; furthermore with a thorough optimization of the procedure, the surgical time can be at least equal to the classic approach. We introduced our approach about 10 years ago; after more than 1000 aortic valve replacement via right anterior mini-thoracotomy, we developed with some tips and tricks in the attempt of turning this technique into our choice approach. Indeed, it is our belief that a highly standardized technique is pivotal to perform a safe and valuable procedure.