Recently a number of minimally invasive surgical techniques have been developed in order to reduce surgical trauma especially to avoid median sternotomy and cardio-pulmonary bypass (CPB). In March 1996 we started successfully a clinical trial with the Port Access technique at our institution for the first time in Europe for the treatment of coronary artery single vessel disease. In addition mitral valve disease, aortic valve disease and ASD were treated successfully with minimally invasive surgical techniques. We developed a new minimally invasive surgical technique (Dresden technique) for the treatment of coronary artery multi vessel disease at our institution. Besides we used several minimally invasive surgical techniques without CPB. Our results indicate that minimally invasive surgical techniques routinely used will decrease the morbidity and time of convalescence after cardiac surgery. These techniques can be applied for a variety of cardiac diseases.