Does a bicuspid aortic valve need replacement?

Right at the outset, let me point out that bicuspid aortic valve does not always need surgery. There are a few number of people who continue to lead a total normal life with bicuspid aortic valve and never ever need surgery in the future. However, in certain patients the valve degenerates over a period of time and becomes narrowed in which case, surgical intervention is called for. Regarding your query about minimally invasive surgery, certainly aortic valve can be replaced using a small incision and without cutting the sternum wide open. It can be done through partial sternotomy and a 2-2.5 inch long incision. Also the cut is so placed that it does not show itself and therefore I don't think, you need to worry on that account.