Table 6 shows a low major complications rate of only 1.1%. There was no statistically difference between the Evolution and Evolution R/L group. The major complications consisted two times a sternotomy in the R/L group due to tamponade because of dissection in the VCS / RA and apex of the RV (during traction / counter-traction). All patients survived. Table 4 also shows a low total minor complication rate of 4.9% without a statistically difference between the Evolution and Evolution R/L group. In the Evolution group 2-times pneumothorax, managed with a drain and 2-times a bleeding from the extraction puncture side, managed surgically. In the R/L group 1-times pneumothorax, managed with a drain and 4-times bleeding: 2-times from the extraction puncture side, managed surgically. One time haematothorax, managed with a drain and one time mediastinal haematoom, managed conservatively.